SEEG SINGAPORE 2021 : Fronto-mesial seizures

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

4th Asian Training Course - september 12-15, 2021

2 000 euros

Registration fee includes :
• Access to all workshops, sessions and training material
• 3 nights accommodation on site (from September 12-15, 2021 )
• Students and Faculty are expected to stay on site during the whole duration of the training course
• 3 breakfasts, 3 buffet -lunches , 6 coffee-breaks)

LAST/ FAMILY NAME *

First/Surname *

COUNTRY *

GENDER *

Male

Female

Email address 1 *

Email address 2 ( optional)

SPECIALTY *

Neurologist

Neurosurgeon

Other

IF OTHER, PLEASE SPECIFY

Name and City of your Institution/Hospital/Center/University *

Phone Number *

Will you join the Faculty dinner ? (if the sanitary situation allows it) *

Yes

Allergies/Special diets

Are you currently performing SEEG ? *

Yes

If not, when are you planning to start ?

How many SEEG courses have you attended ? *

Please list travel or other restriction if any

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms