REJOIN APPLICATION FORM

REJOIN APPLICATION

We would be delighted to have you return to membership. We need to understand what you have been doing since you left us.
Name*

First NameLast Name
Previous name

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Have you been maintaining your HCPC and/or CSP professional registration?*

YesNo
Please provide your HCPC and CSP registration numbers
Have you been maintaining your CPD activity relating to acupuncture? Evidence should include an outcome and reflection*

YesNo
Upload your CPD evidence here:

Cancelof
In relation to your thoracic acupuncture activities, please confirm that: a) information provided to AACP is correct, accurate and complete. b) you are not aware, of any matters which may lead to a circumstance, complaint or claim against you or your work. c) you have not had any claim or loss, whether successful or not, ever occurred or been made against you in respect of any risk now to be insured under AACP membership.

I confirm statements a, b and c aboveI would like to discuss further with AACP
Have you continued to practice acupuncture? Is so, please provide a statement to explain to what extent you practice and in what capacity.*
Your submission will be reviewed by our Clinical Advisor, and we will advise on your best route to return to membership.

We aim to respond with your options within 7 days.
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