Please complete all sections

If you are applying for advanced assessment review to become an advanced practitioner, you MUST have one of the seven qualifications listed above, and your Professional Body MUST be actively responsible for monitoring your Continued Professional Development. You will be required to bring your CPD folder to the peer review for discussion.

DBS Enhanced Disclosure: It is essential that all case managers working with vulnerable adults & children must obtain an enhanced disclosure.

In line with best practice, all practitioners are expected to have a clinical supervisor with experience in brain injury and complex case management.

All practitioners working in the UK must hold a current insurance policy covering them for malpractice and public liability, endorsed for case management.

Please provide us with two written references, these can be emailed to the BABICM administrators at secretary@babicm.org (a sample letter is down loadable to help you request a reference):

1) From your current employer/supervisor.
2) From a professional referee to whom you have provided case management services, together with details of the work undertaken.

Please note, the date of the references must be within 2 months of the date of the signature of the applicant on this application form. If circumstances lead to the review being postponed for over 18 months, it may be necessary to obtain new references.

The cost of the advanced membership review is £200.

I, the undersigned, hereby apply to for Advanced membership of The British Association of Brain Injury & Complex Case Management Limited. I agree to be bound by the BABICM Competency Framework. A copy of which I received from BABICM and have retained for record purposes. I grant permission for my membership records to be held on computer for the purposes of handling membership, publishing the members’ register and mailing out membership information.