REGISTRATION

Our next meeting will take place in Bangkok, Thailand from March 30 to April 1, 2023.
If you would like to join us, please fill out the form below.

Create your account

* Email

* Password

Strength: Very Weak

* Name

* Address

* Phone

Medical Information

* Clinic / Hospital Name

* Clinic / Hospital Phone

* Clinic / Hospital Address

* WhatsApp

* Medical School

* Date of Graduation

* Country of Medical Licensure

* License Number

* Date of Medical Licensure

* Medical Specialty

* Please upload a copy of your Medical License

Drop file here or click to select.

Maximum upload file size: 2mb | .jpg .png .pdf

* Please upload a copy of your Medical Diploma

Drop file here or click to select.

Maximum upload file size: 2mb | .jpg .png .pdf

Hair Restoration Experience

* Hair Restoration Experience

Yes

* FUE / FUT

* FUE Experience

Yes

* FUE Expertise

* More Experience Information

How you want to pay?

Auto Debit Payment

Manual Payment