Non-ASAPS Members - ANZBCPS Board Certified Cosmetic Plastic Surgeons

My Name

First Last

My Qualifications (Post Nominals)

My AHPRA Registration Number

My Email Address

Clinic Name (if applicable)

Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone:

Email:

Website:

I confirm that I meet the Eligibility Criteria set out in the Rules for use of the Certification Trademark, being that I:

have been admitted as a Fellow of RACS specialising in plastic and reconstructive surgery

am registered as a specialist in plastic surgery by AHPRA or MCNZ (as applicable)

am of good repute and have generally conducted myself professionally having regard to the Code of Ethics

am currently active and practice cosmetic plastic surgery

am a current and approved member of the Australian Society for Plastic Surgeons or the New Zealand Association of Plastic Surgeons

am currently subscribed with RACS as my CPD home

have completed this year's RACS CPD Requirement

My RACS Fellowship (Certificate or Letter of Admission)

Max. file size: 100 MB.

Letter of good standing with ASPS or NZAPS

Max. file size: 100 MB.

Please note submission of this form will confirm:

All above information and documents I have submitted are true and unaltered.

I understand this is an application for board eligibility. Once approved, I will be emailed a link to upload my CPD for board certification.

Application Form for Non-ASAPS Members