{"id":2897,"date":"2025-07-30T21:38:25","date_gmt":"2025-07-30T21:38:25","guid":{"rendered":"https:\/\/cosmeticsurgery.org\/fellowships\/?page_id=2897"},"modified":"2025-08-27T20:50:30","modified_gmt":"2025-08-27T20:50:30","slug":"fellowship-certification-request-form","status":"publish","type":"page","link":"https:\/\/cosmeticsurgery.org\/fellowships\/fellowship-certification-request-form\/","title":{"rendered":"Fellowship Certification Change Request Form"},"content":{"rendered":"\n<p>AACS Fellowship Program Directors, before submitting a request to change the AACS certification of your Fellowship Program, please review the Guidelines to ensure you can meet or exceed the outlined requirements.<\/p>\n\n\n\n<p>As outlined on page 16 of the General Cosmetic Surgery Fellowship Guidelines, the program must support a minimum of 300 procedures, specifically 50 breast, 50 body, 50 facial and 50 derm procedures.<\/p>\n\n\n\n<p>Facial programs are required to support 125 or more major facial cosmetic procedures. Of the 125 procedures, each fellow must complete 20 Blepharoplasties, 15 Rhytidectomies, and 15 Rhinoplasties. These requirements are outlined on pages 16-17 of the Facial Cosmetic Surgery Fellowship Guidelines.<\/p>\n\n\n\n<p>Please complete the following form, including a summary of your cases from the past year using this form for general cosmetic surgery fellowship or this form for facial cosmetic surgery fellowships.<\/p>\n\n\n\n<p>Once the form is received, your request will be reviewed by the Fellowship Committee. Their decision to approve or deny your request will be communicated to you when a quorum has been met.<\/p>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-eeabffb5 alignfull uagb-is-root-container\"><div class=\"uagb-container-inner-blocks-wrap\">\n<div class=\"wp-block-uagb-container uagb-block-9ebc80fe\">\n<a class=\"gb-button gb-button-0c6630c3 gb-button-text\" href=\"https:\/\/cosmeticsurgery.org\/fellowships\/wp-content\/uploads\/2025\/04\/facial_summary_case_listing.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">&nbsp; &nbsp;&nbsp;FACIAL&nbsp;SURGICAL LOG SUMMARY<\/a>\n<\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-85d52dc3\">\n<a class=\"gb-button gb-button-04511bca gb-button-text\" href=\"https:\/\/cosmeticsurgery.org\/fellowships\/wp-content\/uploads\/2025\/04\/1.20_case_listing_summary-fi.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">GENERAL SURGICAL LOG SUMMARY<\/a>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-381bdf55 alignfull uagb-is-root-container\"><div class=\"uagb-container-inner-blocks-wrap\">\n<div class=\"wp-block-uagb-container uagb-block-d671ad68\">\n<a class=\"gb-button gb-button-f0c00821 gb-button-text\" href=\"https:\/\/cosmeticsurgery.org\/fellowships\/wp-content\/uploads\/2025\/04\/Consent-Liability_Waiver_DOC.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Consent \/ Liability Waiver<\/a>\n<\/div>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\t\t\t<link rel=\"stylesheet\" property=\"stylesheet\" href=\"https:\/\/cosmeticsurgery.org\/fellowships\/wp-content\/plugins\/happyforms-upgrade\/bundles\/css\/frontend.css\" \/>\n\t\t\t\t<!-- HappyForms CSS variables -->\n\t<style>\n\t#happyforms-2895 {\n\t\t--happyforms-part-title-font-size: 16px;\n--happyforms-part-description-font-size: 12px;\n--happyforms-part-value-font-size: 16px;\n--happyforms-submit-button-font-size: 16px;\n--happyforms-color-primary: #000000;\n--happyforms-color-success-notice: #ffffff;\n--happyforms-color-success-notice-text: #000000;\n--happyforms-color-error: #f23000;\n--happyforms-color-error-notice: #ffeeea;\n--happyforms-color-error-notice-text: #f23000;\n--happyforms-color-part-title: #000000;\n--happyforms-color-part-value: #000000;\n--happyforms-color-part-placeholder: #888888;\n--happyforms-color-part-description: #454545;\n--happyforms-color-part-border: #dbdbdb;\n--happyforms-color-part-border-focus: #7aa4ff;\n--happyforms-color-part-background: #ffffff;\n--happyforms-color-part-background-focus: #ffffff;\n--happyforms-color-submit-background: #019cdf;\n--happyforms-color-submit-background-hover: #000000;\n--happyforms-color-submit-border: ;\n--happyforms-color-submit-text: #ffffff;\n--happyforms-color-submit-text-hover: #ffffff;\n--happyforms-color-table-row-odd: #fcfcfc;\n--happyforms-color-table-row-even: #efefef;\n--happyforms-color-table-row-odd-text: #000000;\n--happyforms-color-table-row-even-text: #000000;\n--happyforms-color-dropdown-item-bg: #ffffff;\n--happyforms-color-dropdown-item-text: #000000;\n--happyforms-color-dropdown-item-bg-hover: #f4f4f5;\n--happyforms-color-dropdown-item-text-hover: #000000;\n--happyforms-color-divider-hr: #cccccc;\n--happyforms-color-choice-checkmark-bg: #ffffff;\n--happyforms-color-choice-checkmark-bg-focus: #000000;\n--happyforms-color-choice-checkmark-color: #ffffff;\n--happyforms-color-rating: #cccccc;\n--happyforms-color-rating-hover: #000000;\n--happyforms-color-multistep-info-text-color: #000000;\n--happyforms-color-multistep-info-back-color: #000000;\n--happyforms-color-multistep-info-back-color-hover: #000000;\n--happyforms-poll-bar-color: #e8e8e8;\n--happyforms-poll-link-color: #000000;\n--happyforms-poll-winner-color: #000000;\n\t}\n\t<\/style>\n\t<!-- End of HappyForms CSS variables -->\n\t\t<!-- HappyForms Additional CSS -->\n\t<style data-happyforms-additional-css>\n\t\t<\/style>\n\t<!-- End of HappyForms Additional CSS -->\n\t\t\t<link rel=\"stylesheet\" type=\"text\/css\" href=\"https:\/\/cosmeticsurgery.org\/fellowships\/wp-content\/plugins\/happyforms-upgrade\/core\/assets\/css\/no-interaction.css\">\n\t\t<div class=\"happyforms-form happyforms-styles\" id=\"happyforms-2895\">\n\t\t\n\t<form action=\"\" id=\"happyforms-form-2895\" method=\"post\" novalidate=\"true\" autocomplete=\"off\">\n\t\t\t\t<input type=\"hidden\" name=\"happyforms_random_seed\" value=\"136097818\" \/>\n\t\t\n\t\t\t<input type=\"hidden\" name=\"action\" value=\"happyforms_message\">\n\t\t\t\t<input type=\"hidden\" name=\"client_referer\" value=\"\">\n\t\t\t\t<input type=\"hidden\" name=\"current_post_id\" value=\"\">\n\t\t\t\t<input type=\"hidden\" name=\"happyforms_form_id\" value=\"2895\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"happyforms_step\" value=\"0\" \/>\n\t\n\t\t<div class=\"happyforms-flex\">\n\t\t\t\t<label for=\"2895-number\" class=\"screen-reader-text\">Leave this field blank<\/label>\n\t<input type=\"text\" id=\"2895-number\" name=\"2895-number\" style=\"display: none;\" tabindex=\"-1\" autocomplete=\"off\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-show\" id=\"happyforms-2895_single_line_text_0-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_0\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-2895_single_line_text_0\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Program Director Name: *<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\">(optional)<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-2895_single_line_text_0\" type=\"text\" name=\"2895_single_line_text_0\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-show\" id=\"happyforms-2895_single_line_text_1-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_1\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-2895_single_line_text_1\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Fellowship Program: *<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\">(optional)<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-2895_single_line_text_1\" type=\"text\" name=\"2895_single_line_text_1\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice display-type--block happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-show\" id=\"happyforms-2895_radio_2-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_2\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-2895_radio_2\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Current Fellowship Certification: *<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\">(optional)<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_2_option_1753910943117\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"2895_radio_2\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Facial<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_2_option_1753910943123\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"2895_radio_2\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">General<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--with-autocomplete happyforms-form__part happyforms-part happyforms-part--email happyforms-part--width-full happyforms-part--label-show\" id=\"happyforms-2895_email_3-part\" data-happyforms-type=\"email\" data-happyforms-id=\"email_3\" data-happyforms-required=\"\">\n\t\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-2895_email_3\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Program Director Email: *<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\">(optional)<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t<input type=\"email\" name=\"2895_email_3\" id=\"happyforms-2895_email_3\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice display-type--block happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-show\" id=\"happyforms-2895_radio_4-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_4\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-2895_radio_4\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Change in certification: *<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\">(optional)<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_4_option_1753910990495\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"2895_radio_4\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Add a Training Fellow<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--attachment happyforms-part--width-full happyforms-part--label-show\" id=\"happyforms-2895_attachment_5-part\" data-happyforms-type=\"attachment\" data-happyforms-id=\"attachment_5\" data-happyforms-required=\"\" data-happyforms-part-id=\"attachment_5\" data-happyforms-max-file-size=\"128\" data-happyforms-max-file-count=\"0\" data-happyforms-allowed-file-extensions=\"csv,pdf,zip,docm,docx,xlsx,xlsm,png\">\n\t<div class=\"happyforms-attachment happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-2895_attachment_5\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">12-month Program Procedure Log: *<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\">(optional)<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t<span class=\"happyforms-part__description\">12-month Program Procedure Log:<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<div class=\"happyforms-upload-area happyforms-input-group with-suffix\">\n\t\t\t\t<input type=\"text\" class=\"happyforms-visuallyhidden\" tabindex=\"-1\" aria-disabled=\"true\">\n\t\t\t\t<div class=\"happyforms-attachment-box\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-attachment-progress\" data-type=\"default\">Choose file<\/div>\n\t\t\t\t\t<div class=\"happyforms-attachment-progress\" data-type=\"uploading\">Uploading\u2026 (<span>0<\/span>%)<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-input-group__suffix happyforms-input-group__suffix--button\">\n\t\t\t\t\t<button type=\"button\" class=\"happyforms-plain-button\" tabindex=\"-1\">Browse<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t\n\t\t\t<div class=\"happyforms-file-notices\">\n\t\t\t\t<div class=\"happyforms-part-error-notice\" data-error-type=\"duplicate\">\n\t\t\t\t\t<p><svg role=\"img\" aria-hidden=\"true\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\" class=\"\"><\/path><\/svg> A file with this name has already been uploaded.<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-part-error-notice\" data-error-type=\"invalid\">\n\t\t\t\t\t<p><svg role=\"img\" aria-hidden=\"true\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\" class=\"\"><\/path><\/svg> This file type isn\u2019t allowed.<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-part-error-notice\" data-error-type=\"size\">\n\t\t\t\t\t<p><svg role=\"img\" aria-hidden=\"true\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\" class=\"\"><\/path><\/svg> This file size is too big.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t<ul class=\"happyforms-attachment__list\">\n\t\t\t\t\t\t\t<\/ul>\n\n\t\t\t<script type=\"text\/template\" class=\"item-template\">\n\t\t\t\t<li class=\"happyforms-attachment-item\" data-attachment-id=\"\">\n\t<div class=\"happyforms-attachment-item__col happyforms-attachment-item__col--main\">\n\t\t<span class=\"happyforms-attachment-item__name\"><\/span>\n\t\t<span class=\"happyforms-attachment-item__size\"><\/span>\n\t<\/div>\n\t<div class=\"happyforms-attachment-item__col\">\n\t\t<button type=\"button\" class=\"happyforms-text-button happyforms-attachment-link happyforms-delete-attachment\">Delete<\/button>\n\t<\/div>\n\t<div>\n\t\t<input type=\"hidden\" name=\"2895_attachment_5[#][id]\" value=\"\" class=\"happyforms-attachment-input__id\" \/>\n\t\t<input type=\"hidden\" name=\"2895_attachment_5[#][name]\" value=\"\" class=\"happyforms-attachment-input__name\" \/>\n\t\t<input type=\"hidden\" name=\"2895_attachment_5[#][size]\" value=\"\" class=\"happyforms-attachment-input__size\" \/>\n\t<\/div>\n<\/li>\t\t\t<\/script>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--attachment happyforms-part--width-full happyforms-part--label-show\" id=\"happyforms-2895_attachment_6-part\" data-happyforms-type=\"attachment\" data-happyforms-id=\"attachment_6\" data-happyforms-required=\"\" data-happyforms-part-id=\"attachment_6\" data-happyforms-max-file-size=\"128\" data-happyforms-max-file-count=\"0\" data-happyforms-allowed-file-extensions=\"csv,pdf,zip,docm,docx,xlsx,xlsm,png\">\n\t<div class=\"happyforms-attachment happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-2895_attachment_6\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Procedure Summary: *<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\">(optional)<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t<span class=\"happyforms-part__description\">View the buttons above.<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<div class=\"happyforms-upload-area happyforms-input-group with-suffix\">\n\t\t\t\t<input type=\"text\" class=\"happyforms-visuallyhidden\" tabindex=\"-1\" aria-disabled=\"true\">\n\t\t\t\t<div class=\"happyforms-attachment-box\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-attachment-progress\" data-type=\"default\">Choose file<\/div>\n\t\t\t\t\t<div class=\"happyforms-attachment-progress\" data-type=\"uploading\">Uploading\u2026 (<span>0<\/span>%)<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-input-group__suffix happyforms-input-group__suffix--button\">\n\t\t\t\t\t<button type=\"button\" class=\"happyforms-plain-button\" tabindex=\"-1\">Browse<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t\n\t\t\t<div class=\"happyforms-file-notices\">\n\t\t\t\t<div class=\"happyforms-part-error-notice\" data-error-type=\"duplicate\">\n\t\t\t\t\t<p><svg role=\"img\" aria-hidden=\"true\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\" class=\"\"><\/path><\/svg> A file with this name has already been uploaded.<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-part-error-notice\" data-error-type=\"invalid\">\n\t\t\t\t\t<p><svg role=\"img\" aria-hidden=\"true\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\" class=\"\"><\/path><\/svg> This file type isn\u2019t allowed.<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-part-error-notice\" data-error-type=\"size\">\n\t\t\t\t\t<p><svg role=\"img\" aria-hidden=\"true\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\" class=\"\"><\/path><\/svg> This file size is too big.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t<ul class=\"happyforms-attachment__list\">\n\t\t\t\t\t\t\t<\/ul>\n\n\t\t\t<script type=\"text\/template\" class=\"item-template\">\n\t\t\t\t<li class=\"happyforms-attachment-item\" data-attachment-id=\"\">\n\t<div class=\"happyforms-attachment-item__col happyforms-attachment-item__col--main\">\n\t\t<span class=\"happyforms-attachment-item__name\"><\/span>\n\t\t<span class=\"happyforms-attachment-item__size\"><\/span>\n\t<\/div>\n\t<div class=\"happyforms-attachment-item__col\">\n\t\t<button type=\"button\" class=\"happyforms-text-button happyforms-attachment-link happyforms-delete-attachment\">Delete<\/button>\n\t<\/div>\n\t<div>\n\t\t<input type=\"hidden\" name=\"2895_attachment_6[#][id]\" value=\"\" class=\"happyforms-attachment-input__id\" \/>\n\t\t<input type=\"hidden\" name=\"2895_attachment_6[#][name]\" value=\"\" class=\"happyforms-attachment-input__name\" \/>\n\t\t<input type=\"hidden\" name=\"2895_attachment_6[#][size]\" value=\"\" class=\"happyforms-attachment-input__size\" \/>\n\t<\/div>\n<\/li>\t\t\t<\/script>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice display-type--block happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-show\" id=\"happyforms-2895_radio_7-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_7\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-2895_radio_7\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">My Fellowship Program has had a site visit within the past 5-years. *<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\">(optional)<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_7_option_1753911152467\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"2895_radio_7\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_7_option_1753911152475\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"2895_radio_7\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--attachment happyforms-part--width-full happyforms-part--label-show\" id=\"happyforms-2895_attachment_8-part\" data-happyforms-type=\"attachment\" data-happyforms-id=\"attachment_8\" data-happyforms-part-id=\"attachment_8\" data-happyforms-max-file-size=\"128\" data-happyforms-max-file-count=\"0\" data-happyforms-allowed-file-extensions=\"csv,pdf,zip,docm,docx,xlsx,xlsm,png\">\n\t<div class=\"happyforms-attachment happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-2895_attachment_8\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Additional information on how my Fellowship Program can support this change.<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\">(optional)<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<div class=\"happyforms-upload-area happyforms-input-group with-suffix\">\n\t\t\t\t<input type=\"text\" class=\"happyforms-visuallyhidden\" tabindex=\"-1\" aria-disabled=\"true\">\n\t\t\t\t<div class=\"happyforms-attachment-box\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-attachment-progress\" data-type=\"default\">Choose file<\/div>\n\t\t\t\t\t<div class=\"happyforms-attachment-progress\" data-type=\"uploading\">Uploading\u2026 (<span>0<\/span>%)<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-input-group__suffix happyforms-input-group__suffix--button\">\n\t\t\t\t\t<button type=\"button\" class=\"happyforms-plain-button\" tabindex=\"-1\">Browse<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t\n\t\t\t<div class=\"happyforms-file-notices\">\n\t\t\t\t<div class=\"happyforms-part-error-notice\" data-error-type=\"duplicate\">\n\t\t\t\t\t<p><svg role=\"img\" aria-hidden=\"true\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\" class=\"\"><\/path><\/svg> A file with this name has already been uploaded.<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-part-error-notice\" data-error-type=\"invalid\">\n\t\t\t\t\t<p><svg role=\"img\" aria-hidden=\"true\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\" class=\"\"><\/path><\/svg> This file type isn\u2019t allowed.<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-part-error-notice\" data-error-type=\"size\">\n\t\t\t\t\t<p><svg role=\"img\" aria-hidden=\"true\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\" class=\"\"><\/path><\/svg> This file size is too big.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t<ul class=\"happyforms-attachment__list\">\n\t\t\t\t\t\t\t<\/ul>\n\n\t\t\t<script type=\"text\/template\" class=\"item-template\">\n\t\t\t\t<li class=\"happyforms-attachment-item\" data-attachment-id=\"\">\n\t<div class=\"happyforms-attachment-item__col happyforms-attachment-item__col--main\">\n\t\t<span class=\"happyforms-attachment-item__name\"><\/span>\n\t\t<span class=\"happyforms-attachment-item__size\"><\/span>\n\t<\/div>\n\t<div class=\"happyforms-attachment-item__col\">\n\t\t<button type=\"button\" class=\"happyforms-text-button happyforms-attachment-link happyforms-delete-attachment\">Delete<\/button>\n\t<\/div>\n\t<div>\n\t\t<input type=\"hidden\" name=\"2895_attachment_8[#][id]\" value=\"\" class=\"happyforms-attachment-input__id\" \/>\n\t\t<input type=\"hidden\" name=\"2895_attachment_8[#][name]\" value=\"\" class=\"happyforms-attachment-input__name\" \/>\n\t\t<input type=\"hidden\" name=\"2895_attachment_8[#][size]\" value=\"\" class=\"happyforms-attachment-input__size\" \/>\n\t<\/div>\n<\/li>\t\t\t<\/script>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t\t\t\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--submit\">\n\t\t<button type=\"submit\" class=\"happyforms-submit happyforms-button--submit \">Submit<\/button>\n\t<\/div>\t\t<\/div>\n\n\t\t\t<\/form>\n\n\t<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>AACS Fellowship Program Directors, before submitting a request to change the AACS certification of your Fellowship Program, please review the Guidelines to ensure you can meet or exceed the outlined requirements. As outlined on page 16 of the General Cosmetic Surgery Fellowship Guidelines, the program must support a minimum of 300 procedures, specifically 50 breast, &#8230; <a title=\"Fellowship Certification Change Request Form\" class=\"read-more\" href=\"https:\/\/cosmeticsurgery.org\/fellowships\/fellowship-certification-request-form\/\" aria-label=\"Read more about Fellowship Certification Change Request Form\">Read more<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":16,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"Fellowship Certification Request Form Page","_seopress_titles_desc":"AACS Fellowship Program Directors, before submitting a request to change the AACS certification of your Fellowship Program, please review the Guidelines to ensure you can meet or exceed the outlined 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