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					                                                                              CONFIDENTIAL
BICA ~ Ordinary Member                                                                          Form 3
Additional Special Requirements                                                                  Tick or /
                                                                                                YES    NO
I confirm that I am able to meet the General Requirements of Form 1 and
the following Special Requirements and that I:
Hold a recognised counselling, clinical psychology, counselling psychology
or psychotherapy qualification to the level of diploma of higher education or
above 1

Practise as an infertility counsellor but am not eligible for accreditation but
agree to seek BICA Accreditation within 2 years of gaining full Membership if
practising in a Licensed Treatment Centre

Practise in accordance with ‘BICA Guidelines for Good Practice in Infertility
Counselling’ 2

Agree to adhere to an acceptable code of ethics and BICA’s complaints and
other policies and procedures                                 Give details


Receive appropriate counselling supervision
                                                                                3
Agree to maintain current, full professional indemnity insurance
[Give details; if personal, agency / policy no.; if through employer, name of Trust / Clinic]

Agree to undertake continuing professional development for a minimum of
30 hours activity per year, 10 hours of which should relate directly to
infertility counselling practice




Declaration
I declare that my full application is accurate, complete and honest to the best of my knowledge. I understand
that any misleading or inaccurate information given or omitted, may, when discovered, invalidate my
application and/or cause my membership and/or accreditation to be withdrawn and my membership
terminated. I accept and fulfil both the general and special requirements relevant to Membership of BICA
and, if practising in a Licensed Centre, will seek accreditation within 2 years of achieving Membership.
Name                                                                                Dated
Proposer / Mentor 4                                             Qualifications
Relationship                                                                        Dated




     BICA Membership & Accreditation Application ~ FORM 3 V10.1
                                                                                                             1
                                                                                CONFIDENTIAL
NOTES FOR COMPLETING FORM 3

NB all forms are designed to be completed on computer as they must be
submitted electronically; the verified copy of certificates should be submitted
separately by post.

1
    Qualifications The Human Fertilisation and Embryology Authority; Code of Practice, 8th ed.
         2009 defines suitable qualifications for infertility counsellors in licensed clinics as:
2.12      All counsellors should have specialist competence in infertility counselling and:
          a] hold a recognised counselling, clinical psychology, counselling psychology or psychotherapy
          qualification to the level of diploma of higher education or above, and
          b] be accredited under the scheme of the BICA [or an equivalent body] or show evidence of
          working towards such accreditation.
2.13      A member of staff appointed to the role of counsellor should be able to provide evidence of being
          an accredited member of, or working towards accredited membership of, a recognised
          professional counselling body. The body should have a complaints/disciplinary procedure, and
          the individual should have agreed to abide by an appropriate code of conduct or ethics.
         This places accreditation central to regulation of counselling in infertility clinics.
2
   ‘BICA Guidelines for Good Practice in Infertility Counselling’ All members are required
to accept and, if practising as infertility counsellors, practise within the BICA ‘Guidelines for
Good Practice in Infertility Counselling’ and the specific Codes of Practice relating to Ethical
Practice, Continuing Professional Development [CPD], Fitness to Practise and Appointment of
an Executor, Complaints and Equal Opportunities. These are all published in the ‘Guidelines
[BICA, Version 2, Sheffield, 2007; ISBN 1– 901406-35-0] and also on the BICA website
www.bica.net. The requirements reflects those in the HFEA Code of Practice, para 2.13; Edition
8 [2009]. If candidates adhere to another Code of Ethics, they should specify which one.
3
  Insurance All practising infertility counsellors should have adequate indemnity insurance
cover for professional practice; this may be provided by themselves if practising independently
and/or privately, or by an employer.
4
   Proposer/Mentor is preferably a current BICA accredited / senior accredited member. S/he
should countersign the declaration when the full form has been completed, prior to submission.
[Until 2010 Mentors may be experienced infertility counselling members of BICA intending to
seek accreditation themselves.] The Proposer should know the applicant well enough to confirm
that they are:
         A responsible person
         Someone who maintains a professional standard of integrity
         Someone who is of good standing within their professional community.
The Proposer should not be ~
         the supervisor who has submitted a report for this application.
         a client or an ex-client of the applicant.
         the spouse, partner or a close relative of the applicant.
As Proposer, your name on the form shows that you support the applicant in their application to
become a BICA Member. A Member intending to seek accreditation in due course should seek a
Mentor who will provide mentorship and guidance whilst the Member develops their expertise in
the field




BICA Membership & Accreditation Application ~ FORM 3 V10.1
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