Registration Form - FMSHK Annual Scientific Meeting 2021 [Online meeting on 3 - 4 Jul 2021]
Theme: Personalised Medicine for Hong Kong
Date: 3 Jul 2021 (Sat) - 4 Jul 2021 (Sun)
Time: 12:30 - 18:00 (3 Jul)/ 13:00 - 18:00 (4 Jul)
Registration Fee: Free

Registration Deadline: 25 Jun 2021 (Friday)
1. Salutation (Please select as appropriate) *
2. Last Name - in capital letter (e.g. CHAN) *
3. First Name (e.g. Simon Tai Man ) *
4a. Email address *
4b. Email address [double confirm] *
5. Mobile No. *
6. Occupation (Please indicate your profession in the full name e.g. Doctors/ Nurses/ other Allied Health Professionals etc.) *
7. Please select the College(s) for CME (if not applicable, please select N/A ) *
8. MCHK registration no. (if not applicable, please enter N/A). *
9. Please indicate your MCHK CME Administrator or CME Programme(s) you have enrolled (if not applicable, please select N/A). *
10. HKMA member no. (if not applicable, please enter N/A). *
11. HKDU member no. (if not applicable, please enter N/A). *
12. CNE points for Nurses (if not applicable, please select "No") *
13. I am a *
14a. Name of member society [e.g. HKUA / N/A] *
14b. My title in the society *
15. I would like to join the ASM *
Required
Personal Data Collection Statement
1) The personal data provided by you will be used by Federation of Medical Societies of Hong Kong(FMSHK) for purposes related to the processing of registration, academic, administrative, and statistical purposes.
2) The personal data (including name, address, email and contact number) provided by you will be used by FMSHK for delivering information including any events and functions to be held, courses to be organized and activities related to FMSHK.
3) Your Personal Data will not be transferred to any third party.
Note
1) CME accreditation is in application. CME accreditation result please refer to https://org.icmecpd.hk/event_calendar_view_details.aspx?EventId=60769

CNE accreditation
Day 1 – 4.5 CNE points
Day 2 – 4.5 CNE points

2) Zoom video conference will be arranged. For first time user, it is recommended to install Zoom
before the symposium.

3) Zoom Personal Link will be provided to participants on 30 Jun 2021. With Zoom
Personal Link, no meeting ID or password is required.

4) Participants are recommended to test the provided Zoom Personal Link before 2 Jul 2021
(Friday) to avoid any technical problems.

5) Participants can submit the questions by using the Q&A Box function.

6) Participants are required to complete the whole symposium, and Online Evaluation Form for
ASM, CME/ CNE accreditation.

7) The Online Evaluation Form will be shared with participants after the ASM.

8) E-certificate will be issued to nursing participants ONLY according to the attended hours 3 weeks after the ASM.

9) The Federation of Medical Societies of Hong Kong (FMSHK) reserves the right to cancel or reschedule
the symposium due to any unforeseen circumstances. The FMSHK is not responsible for any
cost incurred by the collaborating organizations or the participants, should cancellation or any changes
take place after any participants registered for the symposium.
I have read and agreed to the above statement *
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