Affiliate Scalp Micropigmentation Practitioner Application

Membership Application Form

Please note. All fields marked with an asterisks (*) are required.

Professional Details

Title *

First Name *

Last Name *

Date Of Birth *

If you have or work at more than one clinic, please put your main clinic here, you will have opportunity to add further clinics in your Member profile once your application has been accepted

Name of Clinics where you currently work *

Clinic / Work Tel No: *

Clinic e-mail address

Clinic / Work Website

Qualifications

Qualifications *

SCALP MICROPIGMENTATION EXPERIENCE

How long have you been practising scalp micropigmentation? *

Where did you initially train as a scalp micropigmentation practitioner? *

How many scalp micropigmentations do you undertake per month (on average)? *

Personal Contact Details

Street Address *

Address Line 2

City *

ZIP / Postal Code *

Country *

Personal e-mail *

This is the email address for all correspondence with the BAHRS, please ensure it is secure as we sometimes send sensitive information.

Tel No *

Referee's name *

NB: Referee must be a BAHRS surgeon member

The BAHRS member who recommended I join the BAHRS

Date *

I confirm that I have read and understood the BAHRS Membership Terms and Conditions, and agree to abide by them. *

I confirm that I have read and understood the BAHRS Professional Standards for Scalp Micropigmentation Practitioner Members, and agree to abide by them. *

I confirm that I have read and understood the BAHRS Code of Conduct for Scalp Micropigmentation Practitioner Members, and agree to abide by them. *

I have successfully completed a level 4 awarding organisation accredited scalp micropigmentation course.

I have successfully completed a first aid course within the last 3 years

I have successfully completed a basic life support course

I have successfully completed a blood born pathogen course.

Please email copies of the above 4 qualifications to admin@bahrs.co.uk

Your data will not be shared with any third party, and the principles of the GDPR 2018 and will be adhered to. The BAHRS will use your personal data for the purposes of your involvement in Association activities. I understand that by submitting this form I am consenting to receiving information about the BAHRS by post, email, online or by phone. *

Your application will not be processed until confirmation of support from the referee is received at president@bahrs.co.uk

An invoice will be sent for the annual membership fee upon approval. NB. Annual membership runs for 12 months from date of payment.