APPLICANT'S DETAILS
PRIMARY CONTACT
The College uses the primary contact details for communication to applicants and members. Please make sure that the primary contact details are up to date.
IDENTITY DOCUMENTS
APPLICANT'S EXTENSION DETAILS
APPLICANT'S INSURANCE DETAILS
MEDICAL REGISTRATION
UNIVERSITY OF GRADUATION
FURTHER TRAINING & EDUCATION
Please provide information of further training and education undertaken in the field of cosmetic medicine. If insufficient space, please upload extra page/s in place provided.
MEMBERSHIPS & REFERENCES
Memberships
References
Please provide names and contact details of three (3) referees.
Referees MUST be registered medical practitioners and should ideally be current Fellows of the College.
Wherever possible, you are encouraged to choose cosmetic medical practitioners who have an interest in or a willingness to assist you through mentorship.
Your elected referees must be able to speak for your knowledge and skills, as well as your practical experience within cosmetic medicine.
Applicant's Declaration(Required)
01. Anti-aging treatments: hormones, vitamins
02. Botulinum toxin hyperhidrosis
03. Botulinum toxin cosmetic upper face
04. Botulinum toxin cosmetic lower face
05. Chemical peel - deep dermal
06. Chemical peel - medium depth
07. Chemical peel - superficial
08. Fat reduction with energy-based devices- heating and/or cooling based devices
09. Fat reduction - Lipo-dissolving treatments (Injection Lipolysis)
10. Fractional laser resurfacing ablative
11. Fractional laser resurfacing non-ablative
12. Laser/IPL treatment of vascular lesions
13. Laser/IPL treatment of pigmented lesions
14. Hair reduction (laser/IPL)
15. Ablative laser resurfacing (Erbium/CO2)
16. Laser tattoo removal
17. Skin rejuvenation (fractional RF)
18. Skin rejuvenation (laser/IPL)
19. Skin tightening - Monopolar RF (e.g. Thermage, Ultherapy & Titan)
20. Plasma skin rejuvenation (portrait)
21. Plasma pen devices e.g. Plexr, ACCOR treatments, e.g. for eyelid reduction
22. HA based fillers - augmentation of folds, e.g. NL's
23. HA based fillers - wrinkles and lines
24. HA based fillers - fine contouring, e.g. around and under the eyes
25. HA based fillers - deep volume filling
26. HA based fillers - Use outside the face
27. HA based fillers - skin hydration
28. Biostimulating injections (e.g. Radiesse, Ellanse & Sculptra)
29. Permanent fillers (e.g. Aquamid)
30. Rhinoplasty - non-surgical
31. Mesotherapy
32. Microdermabrasion
33. Micro-Sclerotherapy
34. Minor excisions and skin biopsies
35. Use of energy-based devices for treatment/removal of raised lesions such as moles
36. Photodynamic Therapy - Acne
37. Photodynamic therapy - solar damage/field cancerisation
38. Phototherapy using red or blue non-coherent light for acne, anti-inflammation
39. Skin needling (Roll CIT/Dermapen)
40. Platelet rich plasma treatments
41. Small volume fat transfer to face
42. Thread lifting under LA
Other procedure achieved and performed - #43 (Description)
Other procedure achieved and performed - #44 (Description)
Write description here and put your grading in the next available field.
OTHER COSMETIC MEDICAL ACHIEVEMENTS AND/OR SERVICES PROVIDED
Publications
Please advise the name of the publication, the topic of the article and the date published.
Teaching/s
Please provide a short description.
Presentations
Please provide a short description.
Mentoring
Please provide a short description.
Please ensure that you have answered all the required fields and uploaded all the required documents before clicking the "Submit" button.