New Customer Registration Form

Registration Form

VTCT Skills (ITEC) Level 7 Diploma in Clinical Aesthetic Injectable Treatments
Personal Details:
Full Name As It Appears On The Professional Register*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Professional Designation

Medical DoctorRegistered NurseRegistered MidwifeDentistPharmacistParamedicRadiographerOperating Department PractitionerDental HygienistDental Therapist
Professional Registration Number/PIN
Are You A Prescriber?*

YesNo
Is English Your First Language?

YesNo
If English is Not Your First Language Have You Completed IELTS?

YesNo
RPL Route: Evidence of Prior Learning/ Proof of Insurance

Evidence of 10 toxin treatments with before and after photos taken 2 weeks apart.Evidence of 10 dermal filler treatments with before and after photos taken on the same day.Video recording x 2 toxin treatments.Video recording x 2 dermal filler treatments.Evidence of Insurance.
To be eligible for RPL, you must provide evidence of your treatments in the form of a logbook for 10 toxin and 10 dermal filler treatments that you have carried out. These treatments must be provided to patients outside of any training facility. To assess the competency of treatments, we must observe you carrying out two toxin treatments and two dermal filler treatments on a patient via a recorded video. Please read the guidance on recording a video.
How did you hear about us?*
Please Specify
Journal/Training Provider/Other
Please Upload The Following Documents

If you wish to follow the RPL route, evidence as listed abovePhoto ID, a copy of your passport or driving licenceA passport style photo taken against a plain backgroundProof of address,
List of acceptable documents: one from the following:
- A valid UK driving licence or passport
- Recent evidence of entitlement to state- or local authority-funded benefits (including housing benefit, council tax benefit, tax credits,
- state pension, educational or other grant)
- Current council tax demand letter or statement
- Current bank statements or credit/debit card statements
- Current utility bills
List of acceptable documents: one from the following:
- A valid UK driving licence or passport
- Recent evidence of entitlement to state- or local authority-funded benefits (including housing benefit, council tax benefit, tax credits,
- state pension, educational or other grant)
- Current council tax demand letter or statement
- Current bank statements or credit/debit card statements
- Current utility bills
File Upload

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Payment Terms
- MODULE 1: PRINCIPLES OF AESTHETIC PROCEDURES
- MODULE 2: PRINCIPLES AND PRACTICE OF AESTHETIC PATIENT ASSESSMENT
- MODULE 3: ANATOMY & PHYSIOLOGY FOR AESTHETIC PROCEDURES
- MODULE 4: PRINCIPLES & PRACTICE OF BOTULINUM TOXIN USE IN AESTHETIC PRACTICE
- MODULE 5: PRINCIPLES & PRACTICE OF DERMAL FILLER USE IN AESTHETIC PRACTICE
- MODULE 6: LITERATURE REVIEW SKILLS FOR CLINICAL STUDY IN AESTHETIC PRACTICE
- MODULE 1: £1000
- MODULE 2: £1000
- MODULE 3: £1200
- MODULE 4: £1200
- MODULE 5: £1400
- MODULE 6: £2200 Final module, includes certification, assessments, and final externally set exam.
- CONTACT US FOR RPL PRICING AND UP FRONT CONCESSIONS
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