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b2b encounters | Buyer Registration Form
Sending this form does not automatically gets you registered. We have a very strict selection process. Your registration is subject to approval after evaluation. So please be ready to provide some extra information about your company after our response to your registration inquiry.
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* Indicates required question
Company Information
Name of your company / institution
*
Your answer
Category
*
Health Insurance
Assistance
Medical Travel Agency
Other:
Country
*
Your answer
City
*
Your answer
E-Mail
*
Your answer
Phone
*
Your answer
Website
*
Your answer
Information about your services
For how many years have you been in medical / tourism industry?
*
Your answer
Top countries that you send patients to:
You can mention a few countries
Your answer
Top branches that you send patients for:
Oncology, cardiology, hair transplant etc.
Your answer
Approximately how many patients do you send abroad per year?
Your answer
Why do you think your country is an interesting market for medical tourism?
This is not about receiving patients. This is about why/how you can send patients from your country
Your answer
What are your expectations from this event?
Why do you want to meet some hospitals or clinics?
Your answer
1st Delegate Information
Name
*
Your answer
Surname
*
Your answer
Gender
*
Mr
Mrs
Title / Position
*
Director, marketing coordinator etc.
Your answer
Spoken languages
*
Your answer
E-Mail
*
Your answer
Direct phone number
Your answer
Mobile phone number
Your answer
2nd Delegate Information
Please remember we only cover expenses of one delegate. If you will have 2 delegates you will have to pay for the 2nd delegates costs.
Name
Your answer
Surname
Your answer
Gender
Mr
Mrs
Clear selection
Title / Position
Director, marketing coordinator etc.
Your answer
Spoken languages
Your answer
E-Mail
Your answer
Direct phone number
Your answer
Mobile phone number
Your answer
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