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IPOKRATES Pediatrics Innsbruck 2017
April 10 -14, 2017 at the Pediatric Departement of the Medical University of Innsbruck

Prof. John Graef, MD & Prof. Clifford Lo, MD
Children's Hospital, Harvard Medical School, Boston, USA

ANMERKUNG: TEILNAHME GESCHLOSSEN
Aufgrund der großen Nachfrage, ist leider keine Anmeldung mehr für das Ipokrates Students Seminar in Innsbruck möglich.

Name
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Address
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E-Mail Address
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Phone Number
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University
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Semester
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Please tell us in a few sentences why you would like to participate in our seminar: *
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I bring with me the following pediatric qualifications for this seminar:
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I learned about this IPOKRaTES seminar through:
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Seminar Fee
The charge for the seminar will not exceed EUR 135,00 (board and lodging not included).
Students from the Medical University of Innsbruck will be returned 50 Euros from the 'Medizinische Hochschülerschaft Innsbruck' (ÖH).
The charges will cover the expenses for flights and lodging of the visiting lectureres.

IPOKRaTES Students is a non-profit organization!

Selection of participants is subject to IPOKRaTES Students. Early applications will be favoured. Cancellation at short notice cannot be accepted.

Vaccination Document
In order to guarantee you complete access to all pediatric wards, we will kindly ask you to send us a copy of your vaccination status. This one should include the common childhood vaccinations which are performed in Austria and Germany (measels, mumps, rubella, chickenpox - the latter may also be proven by anamnestic history). A vaccination against hepatitis B ist further recommended.
Contact
If you have any questions please do not hesitate to contact us via email:
innsbruck@ipokrates.com (cc: ch.mayerhofer@hotmail.com)
Next Steps
Having sent us this form, you will receive a confirmation of your application via email.
Regrettably we are unable to guarantee a definite participation due to the limited number ofavailable spaces (up to 20).
Having assigned the spaces, we will send you a confirmation of course registration as well as our banking information. Please transfer the course charge as soon as possible, since we cannot book your place on our workshop prior to this. Please indicate the reference for your transfer as follows: „IPOKRaTES Students Seminar Pediatrics
Innsbruck 2017 YourName“. Unfortunately, we are unable to reimburse course charges in case of cancellation at short notice. The spaces of our seminar cannot be assigned to other students without prior consultation with a staff member of IPOKRaTES STUDENTS.
Please do not hesitate to contact us with your questions via email.
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