Request a Certificate Please use the form below to certify completion of your RET or MRET requirements. All fields that apply to you are required. Certificate Requested: RET MRETName: Mailing Address: Contact Phone: Email: Date and location of Certification you attended: Month: –Select–JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year(yyyy): Location (OR, UT, TX…): By submitting this form to the Rapid Eye Institute, I certify that the information above is true and correct to the best of my knowledge and that I have completed the required hours of practicum for the level of certificate I’m requesting. I understand that my Certificate must be renewed annually in December.
