• ABHRS APPLICATION

    Lifetime Achievement Route
  • Please use this form as a tool to ensure that all needed information for your application is sent in. In order to submit this form, all checkboxes need to be completed.

    Please click save at the bottom if you need to return later to complete the form. An email will be sent to you with a link to continue later. 

  • Upload Government-Issued ID
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  • Upload M.D. or D.O. License
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  • Upload Certification
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  • Upload Reference Letters
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  • Upload Curriculum Vitae
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  • Upload Physician Profile
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  • Upload Attendance
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  • For example, if application is dated August 20, 2020 then case log will include cases from

    August 2012 – July 2013 listing 50 cases          August 2016 – July 2017 listing 50 cases
    August 2013 – July 2014 listing 50 cases          August 2017 – July 2018 listing 50 cases
    August 2014 – July 2015 listing 50 cases          August 2018 – July 2019 listing 50 cases
    August 2015 – July 2016 listing 50 cases          August 2019 – July 2020 listing 50 cases*

     

  • Upload Case Logs
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  • Upload Operative Reports
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  • Upload Before and After Photos
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  • Upload CME Credit Hours
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  • Should be Empty: