Laparoscopy Principals and Practice Workshop 2025

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Estimated time to complete: 5 minutes

Please fill in the below questions that are required

Email *

Attendee name (for certificate) *

Attendee email address *

Attendee preferred name for tag *

Attendee mobile number *

Clinic name *

Clinic Phone Number *

Emergency contact name (cannot be a participant) *

Emergency contact contact number *

What is your experience level with laparoscopy? *

None at all

Have observed/assisted with some

Have used laparoscopy for minor surgery

Have used laparoscopy for major surgery

Please share a little bit about your experience in this subject *

What skills or knowledge would you like to gain from this workshop? *

Attendee - Dietary requirements (ie. vegetarian) *

Attendee - Reason for dietary requirement? *

Anaphylaxis

Allergy/Intolerance

Preference

Required

Attendee - RSVP to the FREE Social event on Saturday night (most participants attend this event) *

Yes please

No thank you

Yes please, and I'm bringing a plus 1 ($65 cash on the night)

Attendee - I understand that I will only receive the workshop notes in digital format, at least one week prior to the workshop *

Yes

Required

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