Aims and Objectives

• To promote and direct the development of Hair Restoration Surgery in India along sound, scientific, ethical and progressive lines.
• To foster, organize and co-ordinate training in Hair Restoration Surgery and to advise on organization of teaching programmers in the field in India.
• To provide for and promote dissemination and diffusion of knowledge of Teaching of Art and Science of Hair Restoration Surgery amongst members of the medical and Para medical profession in general.
• To create awareness and provide correct and scientifically appropriate information about hair restoration to the general public

Membership criteria

As per the resolution passed in the annual general body meeting held in Lonavala in Oct 2015, only doctors having the following qualifications would be eligible for the membership of Association of Hair Restoration Surgeons, India:

M. Ch. Plastic Surgery

M.D / Diploma in Dermatology

M. S General Surgery

M. S ENT, DORL

Diplomate of the American board of hair restoration surgery.

These criteria will be applicable prospectively from 2016.

To complete this application

• Read the current AHRS Bylaws and Code of Ethics and complete the signature line on the next page. The Bylaws and Code of Ethics can be obtained via the AHRS website www.ahrsindia.com. For any clarifications please contact Dr. Mayank Singh, the Hon. Secretary, at secretaryahrsindia@gmail.com
• Type or print the applications form below in black ballpoint ink. Mail completed form, required supporting materials, and application fee as Bank Draft to:

Dr. Sukhbir Singh, Honorary Secretary AHRS India

Hon. Secretary AHRS India

Resplendent The Cosmetic Studio
R-9, LGF, gk part 1, New Delhi-110048

Alongwith the application, please send your brief resume (CV) and a certified copy of medical registration in the specialty stated.

Send completed application, required supporting materials, and application fee to:

Dr. Sukhbir Singh, Honorary Secretary AHRS India

Hon. Secretary AHRS India

S-347, Panchsheel Park,

Resplendent The Cosmetic Studio

R-9, LGF, gk part 1, New Delhi -110048

Application Fee, subject to change (Invoiced after acceptance. Processing fee of Rs 500/- will be deducted if fee is refunded)

• Associate Member................................... INR 10,000/-
• Overseas Member .................................. US$ 1000/-
• LIFE Membership ................................... INR 20000/-

All the payment in form of Bank Draft / Online Banking only should be forwarded favouring-

"ASSOCIATION OF HAIR RESTORATION SURGEONS"

(payable at Mumbai) The draft in favor of Association, should accompany the application form and sent to the Hony. Secretary and no other direct payments

Indicate: Bank Draft Number: Bank Branch: Amount:

Online Bank details:

Association of Hair Restoration Surgeons

Account Number: 00841450000186

IFSC: HDFC0000084

Bank: HDFC Bank Ltd.

Branch: Imperial Mahal, Gr Floor Khodadad Circle, Dadar T.T. Mumbai-400014 Maharashtra

AFFIRMATIONS

I, hereby apply for membership in the Association of Hair Restoration Surgeons. (Hereafter referred to as AHRS)

In consideration of AHRS processing my application for membership, I hereby grant permission for the AHRS to obtain information regarding hospital staff privileges and actions relating thereto, information from former medical society affiliations, specialty organizations, the Medical Council of India, appropriate State medical councils, medical colleges/ institutes and other organizations providing medical training including internship and residencies.

I further authorize disclosure of information generally considered to be reliable which has a bearing on my professional competence, character and ethical qualifications to all hospitals and medical licensing and discipline boards who request such information.

I hereby release and hold harmless from any liability or loss, the AHRS, its officers, agents, employees and members for acts performed in good faith and without malice in connection with evaluating my application and my credentials and qualifications, and hereby release from any liability any and all individuals and organizations, who, in good faith and without malice, provide information to the AHRS, to its authorized representatives, concerning my professional competence, ethical conduct, character and other qualifications for membership.

I further release from liability the AHRS, its officers, agents, employees and members for delivery of information to any third party as authorized herein provided such delivery occurs prior to the acknowledged receipt, in the office of the AHRS, or a written notice of revocation of this release.

I have read and understand the Bylaws and Code of Ethics. I hereby agree to abide by the Bylaws and Code of Ethics of the ISHRS and agree upon acceptance, that my membership in the ISHRS shall be conditional upon continued compliance of the aforementioned Bylaws and Code of Ethics.

I HEREBY AFFIRM AND REPRESENT THAT ALL STATEMENTS, ANSWERS AND INFORMATION CONTAINED IN THIS APPLICATION ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF

CHECKLIST

• Application Form.
• Countersigned copy of pay-in slip and copy of the cheque deposited.
• Prescribed Fee in form of Bank Draft for overseas applicants.
• Certified Copy of Medical Registration in specialty of practice
• Curriculum vitae
• Short description of your hair transplantation practice.
• Affirmation duly signed.
• One stamped self-addressed envelope.
• 02 passport size photographs - one pasted on form and the other appended to the application form with name on reverse.