Registration

Name of training course*
Address line 1*
Address line 2*
Town*
County*
Post code*
Telephone Number*
Mobile Number*
Email Address*
Name of main contact*
Please note that the main contact will be set up with a login for the online Training Provider portal
Main contact telephone*
Main contact email*

Is all training carried out in the UK, Northern Ireland, Isle of Man and Channel Islands?*
- Yes
- No
Please state the type of procedures that training is being provided for e.g. dermal fillers botulinum toxin, laser etc*
Please provide details of any specific products used on the training course e.g. Vistabel or Dysport.*
Please state the name of all trainers along with their GMC/GDC/NMC membership number*
Trainer GDC/GMC/NMC Number
Have any of the trainers or the training organisation received any complaints or malpractice claims over the last 3 years?*
- Yes
- No
If yes please provide full details
In order for an organisation to be accepted as a Hamilton Fraser Insurance Recognised Training Course, you and your trainers must be insured for Medical Malpractice Liability Insurance, including training cover for the procedures being taught. (Use additional sheets if necessary)

Please provide the following details for your organisation and trainers:
Insurer*
Limit of Indemnity*
Policy Excess (if applicable)
If you and your trainers have no insurance in place please state why*

Please specify the location(s) of your training course(s)*
What are your training course acceptance criteria for delegates applying to attend your course?*
How do you check this criteria e.g. whether they are a GDC, GMC member?*
How many delegates do you accept on each training course?*
How many delegates have you trained in the past 12 months?*
How many delegates do you propose to train in the next 12 months?*
Please provide details of how you assess delegates at the end of your training course, including details on any post course support provided e.g. mentoring/helpline etc*
How many delegates have failed your course over the past 3 years?*
Do your delegates receive a certificate of competence? (Please include a copy of your training certificate)*
- Yes
- No
Certificate of competence*
Accepted file types: jpg, png, pdf, doc, docx.
What is your annual fee turnover in respect to the training course you run?*

Website
Twitter Link
Facebook Link
LinkedIn Link
Please supply a short profile of your training course/company*
We will soon be developing a members only area of our website where our customers can gain access to the latest promotions and offers for training courses.
Would you be interested in being featured with this initiative once launched?*
- Yes
- No
Who attends your training courses?*
- Doctors
- Dentists
- Nurses
- Other
Other (please state)
Are you aware of how to register a new product that you would like to use with your insurance?*
- Yes
- No
If 'No', please contact a member of the Hamilton Fraser Cosmetic Insurance team on 0800 63 43 881 to add a product.
We can insure your clinic - Let us provide you with a quote. Please enter your renewal date and contact number below:
Renewal Date*

When returning this form please provide us with the following: (We can not process your application without them)
Trainer CV's*
Please include a CV with past medical experience and training/tutoring experience for the trainers listed above. We would expect the trainers to have had at least 12 months experience in performing the treatments as a practitioner in their own right and be able to provide evidence of teaching and tutoring qualifications.
Drop files here or

Accepted file types: pdf, doc, docx.
Course syllabus and structure*
Accepted file types: pdf, doc, docx.
Training certificate*
Accepted file types: pdf, doc, docx.
Insurance policy certificate*
Accepted file types: pdf, doc, docx.
- Hamilton Fraser Insurance can terminate your Recognised Training Course status if you breach any of the terms and conditions
- Hamilton Fraser Insurance can terminate your use of the Recognised Training Course logo if we believe that your use is likely to damage our reputation
- You can only use the Recognised Training Course logo in accordance with our specific guidelines
- You can only become a Recognised Training Course on successful completion of the application process
- You will only receive exclusive offers and promotions when they are available and subject to change without you being told. Details of our current promotions will be posted on our website www.hfis.co.uk
- Special offers and promotions are not exchangeable
- Hamilton Fraser Insurance reserves the right to terminate an advert or article if we believe that your use is likely to damage our reputation
- Hamilton Fraser Insurance reserves the right to refuse an advert or article
- You agree to update Hamilton Fraser Insurance if you change the structure of your training course
- Your Recognised Training Course status will be cancelled if you fail to meet the above terms and conditions

Step 1 of 6 - About you