Terms and Conditions of Insurance

I hereby state that I have no knowledge of any incident, pending claims, suits, or other ethics violations nor have any been filed against me in the past pertaining to my practice as a practitioner, that no certifications or licenses have been revoked, and that I have never been arrested for or been charged with any sexual violation.

I understand that this application is subject to approval with no automatic inclusion in the program. My digital signature shall verify that I have completed this application accurately and honestly and that I agree to provide proof of training should I be asked to provide it in the event of a claim.

I understand that I am responsible to verify that the coverage is appropriate to my training and professional activity, and that activities outside the scope of coverage of the policy are not covered.

I understand that any false statement made on this application or subsequent renewals shall void this application and render my insurance coverage null and void.

I understand that the comprehensive coverage provided by EMPA covers liabilities that result from my actions as an individual professional practitioner and associated general liability. I further understand that the business name listed on the application is included for the sole purpose of promoting my professional practice in the Practitioner Directory and is not covered as a separate entity by this policy except for liabilities arising directly from the covered activities of my professional practice. 

I understand and agree to pay a fee or $35 or 10% of the cost of the transaction, whichever is greater, for returned checks or for credit card payments that are either disputed or refunded by a third party. 

I understand that if my applicationis approved, the premium/fees paid by me are nonrefundable, nontransferable and will not be prorated. This application is for a policy which will expire 12 a.m. April 1 each year. Denied applications will be refunded less any associated fees resulting from the method of payment (i.e. credit card charges).

I understand and agree to follow the EMPA Code of Ethics and understand that activities outside the EMPA Code of Ethics may void coverage. 

EMPA Code of Ethics.

The information in this directory is provided by its members. The listing of any area of practice by a practitioner has not been reviewed by the EMPA staff. It is merely an indication by the member of an area or areas in which he or she practices Any complaints or comments may be directed to This email address is being protected from spambots. You need JavaScript enabled to view it.. EMPA holds the right to remove a member at the discretion of EMPA. Reasons for removal may include, but are not limited to: large amount of complaints by other members, inappropriate content, use of Practitioner Directory for commercial solicitation, and ethical violations.