MBCT Facilitation Certificate Request Form

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The Centre for Mindfulness Studies will issue an MBCT Facilitation Certificate to trainees who have completed the required training modules in Steps 1, 2, 3 as described at https://www.mindfulnessstudies.com/pro-dev/mbct-cert/.

Email *

First Name *

Last Name *

Your Name (exactly as it should appear on the certificate) *

Please note that CMS will not include professional designations or credentials on facilitation certificates.

Please indicate when you completed the MBCT training modules listed below (approximate dates are fine)

Mindfulness Core Concepts *

Or MBCT Basics if completed in 2021 or earlier.

YYYY

CBT Meets Mindfulness *

Or CBT Primer if completed in 2019 or earlier.

YYYY

MBCT Teacher Training Intensive *

YYYY

MBCT Practicum *

YYYY

MBCT Mentorship *

YYYY

Approved Mentor *

Which Centre-approved mentor submitted your Mentorship Completion Form?

Inquiry Essentials *

YYYY

Send me a copy of my responses.

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