Applicant Information
Full Name
Nationality
Country of Residence
Email Address
WhatsApp Number
Instagram or Website, if applicable
Professional Background
Current Profession
Please select
Physician
Dermatologist
Plastic Surgeon
General Practitioner
Nurse
Licensed Aesthetic Practitioner
Other Licensed Healthcare Professional
Other
Please specify your profession if you selected "Other."
Clinic or Organization Name
Country Where Your License Was Issued
License Type
License Number
Years of Clinical Experience
Please select
Less than 1 year
1–3 years
3–5 years
5–10 years
More than 10 years
Years of Experience in Aesthetic Medicine
Please select
Less than 1 year
1–3 years
3–5 years
5–10 years
More than 10 years
Please upload a copy of your professional license or supporting credentials
Training Format
Preferred Training Type
Please select
1:1 Private Session
Small-Group Session, 2–4 participants
Custom Group Program, 5 or more participants
Number of Participants
Please select
1
2
3
4
5 or more
Are all participants from the same professional category?
Please select
Yes
No
Not sure
If there are multiple participants, please list their names, professions, and license types.
Preferred Training Topics
Participants may select up to two treatment topics per 1-hour session.
If you selected "Other," please specify.
Example: learning treatment settings, combination protocols, Korean aesthetic trends, complication management, case design, or practical technique.
What is your main purpose for joining this training?
Please do not upload identifiable patient photos or personal medical information unless requested by the clinic.
Are there any specific cases, concerns, or treatment areas you would like to discuss?
Preferred Schedule
Preferred Training Date
Alternative Training Date
Preferred Time of Day
Please select
Morning
Afternoon
Flexible
When will you be in Seoul?
Certificate
Participants who complete the program will receive a Certificate of Completion — Dr. Eraser Protocol Training.
This certificate confirms participation in the training program only. It does not represent a medical license, professional qualification, or authorization to perform procedures beyond the participant's existing legal scope of practice.
Name to be printed on the certificate
Treatment Model
Eraser Clinic arranges a dedicated treatment model for each training session.
Participants may not bring their own patient or model unless prior written approval is granted by the clinic.
Please note that model suitability, treatment selection, and demonstration format are subject to clinic review and approval.
Do you have any specific model or treatment demonstration request?
Photography and Video Policy
Photography during the theory session may be permitted.
Video recording is not permitted at any point during the program, including theory, live demonstration, and hands-on portions.
Photography or video of the treatment model is not permitted unless prior written consent is obtained from both the clinic and the model.
Important Confirmation
Please read and confirm the following:
Additional Message
Is there anything else you would like us to know before we review your application?
Send