JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
VIVERE IN SALUTE PER PROMUOVERE LA SALUTE
09/04/2022
ore 9.00/17
presso SENTIERO CAI Anello Valle San Bartolomeo - Pecetto di Valenza
(Partenza da Grissinificio valle San Bartolomeo )
ACCREDITATO CON 9 CREDITI ECM
MAX 30 POSTI
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
COGNOME
*
Your answer
NOME
*
Your answer
CODICE FISCALE
*
Your answer
CELLULARE
*
Your answer
WHATSAPP
*
Your answer
IN SERVIZIO PRESSO
*
AZIENDA OSPEDALIERA ALESSANDRIA
ASL AL
ASL AT
POLICLINICO DI MONZA (Salus/Citta di Alessandria)
STUDENTE
Other:
QUALIFICA
*
INFERMIERE
INFERMIERE PEDIATRICO
OSTETRICA
STUDENTE
Other:
ISCRITTO NURSIND
*
SI
NO
SE HAI LA TESSERA INDICANE IL NUMERO
Your answer
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
