Application Areola Partner Program

🌐 Business Information

Full Name (Applicant/Owner)*

Business Name*

Business Website*

Email*

Phone Number*

💥 Partner Program Selection

Which Version of the Partner Program Best Fits your Team?
Select the most suitable option based on your team's size and structure:*

Areola Partner Program (Teams up to 5 professionals)Enterprise Plan (For larger organizations with multiple locations)

📍 Business Location

Country*

State/Province*

City*

Full Address*

🌎 Training and Materials Language Preference

Select your preferred language for training sessions and materials:*

English 🇺🇸Español 🇪🇸Português 🇧🇷

🏥 What does your business focus on?

Select all that apply to your organization:

Cancer Treatment CenterPlastic Surgery ClinicHospital with Breast Surgery ServicesAesthetic and Wellness Center (including Medspas)Permanent Makeup or Tattoo ClinicTraining Center or AcademyOther

Please Specify*

💼 What services does your business currently offer?

Check all that apply to your organization:

🎯 What are your primary goals for implementing the Areola Protocol?

Select the options that best describe your objectives:

Enhance patient recovery experienceExpand service offerings for post-surgical careIncrease revenue with new servicesSet your company apart with specialized treatmentsTrain staff to provide advanced solutionsOther

Please Specify*

💡 Do you plan to teach this protocol in the future?

Let us know if you're also planning to offer your own educational programs based on this training.

Yes, we intend to teach this protocol in future trainingsNo, we’ll apply the protocol only within our teamNot sure at the moment.

⏳ Estimated Timeframe for Training Implementation

When would you like to start the in-company training?

As soon as possibleWithin 1-3 monthsBetween 3-6 monthsOther

Please Specify*

👥 Team Size for Training

How many people will receive the training?

1 Person2 - 3 people3 - 5 peopleMore than 5 people or multiple locations: Please specify the exact number of locations and team size per site.

Please Specify*

🖌️ Do you already have staff with experience in permanent makeup or medical micropigmentation?

YesNo

💵 Budget for In-Loco Training*

What is your budget for the Areola Partner Program?
*US Dollars

🌟 How did you hear about the Areola Partner Program?

(Checkbox Options)

Online Search (Google, Bing, etc.)Social Media (Instagram, LinkedIn, Facebook)Industry Event or ConferenceRecommendation from a ColleagueOther

Please Specify*

✉️ Additional Comments or Questions

Use this space to share any specific needs, questions, or observations about the program.

Application Form: Areola Partner Program