JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Registration BPS YRD 2023
Belgian Pain Society Young Researchers Day 2023
Date: April 22, 2023
Location: Campus Aula, Volderstraat 9, 9000 Ghent
Please be aware that registration is free, but attendance after registration is mandatory.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First name
Your answer
Last name
*
Your answer
Country
*
Belgium
The Netherlands
Germany
France
Luxembourg
Other:
Institution (place of work)
*
Your answer
Title
*
Miss.
Mr.
Mrs.
Ms.
Dr.
Prof.
How would you describe your professional role?
*
Clinical practitioner
Researcher
Educator
Industry professional
Student
Other:
Practice/discipline
*
Anaesthetist
Biochemist
Dentist
General Practitioner
General Surgeon - internist
Geriatrician
Lab Technician
Neurologist
Nurse
Occupational Therapist
Oncologist
Orthopedic Surgeon
Paediatrician
Pain Specialist
Pharmacologist
Physical and Rehabilitation Medicine
Physiotherapist
Psychiatrist
Psychologist
Rheumatologist
Social worker
Other:
Do you need accreditation for you participation?
*
Yes
No
I need accreditation from RIZIV/INAMI (rubric
Nationale vergadering/National meeting)
, this is my number:
Your answer
I need accreditation from Pro-Q-Kine, this is my Pro-Q-Kine number:
Your answer
Allergies/food restrictions
*
No restrictions
Vegeterian
Vegan
Other:
See you at the BPS YRD 2023!
You will receive a copy of your answers after sending.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms