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Online Cosmetic Acupuncture UK Application Form

 

To apply for membership of Cosmetic Acupuncture UK, please fill out the online form below. Alternatively, download the pdf on the right for a printable form. The network is exclusively for professional practitioners, and as such, applicants must meet the criteria for membership.

Full Name:
Email Address:
Website URL (Optional):
Contact Number - Personal:
Correspondence Address:
Clinic/Practice Address - Main:

Clinic/Practice Area - Main:
Clinic/Practice Contact Number - Main:
Member of a Registered Acupuncture Body:
If 'Other' please enter details here:
Acupuncture Qualifications and Training:

(25 Words Maximum)
Cosmetic Acupuncture Training:

(25 Words Maximum)

Letters to be used after your name, e.g. Lic.Ac:
Cosmetic Acupuncture Training Required?
Insurance Held:
I have read and I agree to the Terms and Conditions:
 I Agree
 





Postal Application Form


Please download the pdf version of our online Application Form here.




Terms and Conditions


To read the Terms and Conditions, before applying, please click here