Application for Registration of Persons to carry out Acupuncture,
Cosmetic Piercing, Electrolysis, Microneedling, Semi-permanent skin-colouring and Tattooing

Local Government (Miscellaneous Provisions) Act 1982

Treatment(s) to be carried out:        (place a tick beside relevant treatments)

Acupuncture    Cosmetic Piercing    Electrolysis    Tattooing    Semi-permanent skin-  
       colouring

Microneedling
About the business

1.		Business Name & Address (at which the treatments are to be carried out) ..................…………...............................
...........................................................................................…………………………………………………..Postcode..........................................………..Tel:........................................………………………………...	
2.		Full name of Applicant.......................................................................................……………………….......	
3.		Head Office Address (if different from above)…………………………..................………………........................
.............................................................…………………………………………………………………...…….Postcode..............................................Tel:........................................……………………………………....	

About the person offering treatment
1.		Full Name (if different from above)
...........................................................................................................................…………………………....	
2.		Home Address..................…............................................................................…………………….……….
................................................................Postcode...................................................………………………
Tel:......................................................Email:.......................................................................……...……….	
3.		Describe where the treatment is to be given (if other than a registered premises)..........................…….................
..............................................................................................................................………………………….	
4.		Describe arrangements for cleansing of equipment and sterilisation of instruments.................................
..............................................................................................................................………………………….
........................................................................................................................………………………….......	
5.		What qualifications/experience do you have to carry out this treatment......…………..............................
........................................................…………...........................(Copies of certificates must accompany this application)	
6.		Have you ever been convicted of an offence under Regulation 13 - 17 of the Local Government (Miscellaneous Provisions) Act 1982                Yes         No 	

Date:................................................	Signed.................................................................

Payment will be collected by debit or credit card ONLY once your application has been received. 

Please forward your completed form to regulatoryservices@solihull.gov.uk  Alternatively post to:
Food & Safety, Regulatory Services.  Solihull MBC, The Council House, Solihull, B91 3QB. Tel: 0121 704 8018

£259.00 for initial registration and up to 2 persons
£52.50 for additional person or change of person
£209.00 for change of premises
£20.50 administration charge for replacement of certificate/change of details
(Fees charged are for applications submitted between 1/4/26 - 31/3/27)