Request edit access
Registration Form
EPNS Interactive Training Course: principles and practice of child neurology in Infancy
Tashkent, Uzbekistan, 13-15 March
First name *
Your answer
Last name *
Your answer
Place of work *
Your answer
Position *
Your answer
Title (student, resident / master, doctor, assistant, associate professor, professor, etc.) *
Your answer
Country of Residence *
Your answer
Address *
Your answer
Phone number *
Your answer
E-mail *
Your answer
The name of the presentation of the clinical case (should relate to any neurological condition of early childhood (up to 3 years old)) *
Your answer
Check if you would like to receive prize for the best case presentations and will have their registration fee reimbursed *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service