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Symposium
DBS - STATE OF THE ART
Please register below to participate in the symposium.
Title of address
*
...
Prof. Dr.
Dr.
Ms.
Mr.
Mrs
Name + first name
*
Job title
*
...
neurologist
neurosurgeon
general practitioner
doctor specialist in training
nurse specialist
nurse
physiotherapist
occupational therapist
psychologist
other
Workplace (center)
*
Email address
*
RIZIV number
I'll join for lunch.
*
Yes
No
By registering for the congress, you confirm that you have taken note of our
privacy statement
.
*
I hereby also give AZSJ neurology permission to pass on my details regarding participation in the congress to the sponsors. They can use my data for commercial purposes.
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