Registration Form
Malaysia Telemedicine Conference 2017 website
http://med.monash.edu.my/campaign/telemed/index.html
Section A: Participant Details
Title *
Full Name *
Your answer
University / Organization *
Your answer
Preferred Mailing Address *
Your answer
Zip / Postal Code *
Your answer
Country *
Your answer
Telephone No. *
Your answer
Mobile Phone No. *
Your answer
Email *
Your answer
Preference for vegetarian dietary *
Section B: Fees & Certificate
Registration Fees *
Tax Invoice *
Name / Organization
Your answer
Billing Address *
Tax invoice will be billed according to this information and changes are not allowed once tax invoice has been issued.
Your answer
Name to be printed on the Certificate of Attendance
Kindly fill in this column if you are a full delegate and would like to receive the Certificate of Attendance. Certificate will be given out on the last day of the conference.
Your answer
Lunch Conference @ 16 August 2017
There will be a lunch conference titled "The Vision for Malaysia" presented by Steve Lutz and Dr Jason Tee from Cerner Asia on the second day of the conference. Kindly register at the below online registration form if you are keen to join this lunch conference. (Note: This is a separate form from the conference registration, as we are getting the head count for the lunch conference separately)

https://docs.google.com/forms/d/e/1FAIpQLSfC1dxJRgn0pceHMpN9oNVJuBYZyYHP_qgB_5TuB3HS7pgeTg/viewform

The lunch conference details are as below:

Date: 16 August 2017
Time: 1.00 - 2.00 pm

Please join Steve Lutz, Director of Business Development with Cerner Asia, and Dr Jason Tee, Healthcare Executive with Cerner Asia, in a lunch exploration of Cerner’s perspectives on how Industry players can help use contemporary technology, people, and processes to support the regulatory, academic, and provider pillars of the telemedicine governing framework. Steve and Jason will illustrate how Malaysia will leapfrog other international markets once fundamental building blocks are in place, by providing direct examples and outcomes of this journey from other markets in the world.

It is FREE with limited seats, so hurry up and REGISTER NOW! Thank you.

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