SinuCare Balloon Sinuplasty Instructional Course - MENTCON Dec 2017 Mumbai
An instructional course with hands-on training in balloon sinuplasty on anatomical head models by world-renowned faculty. Please fill out the application form below. Since we have limited space for this Instructional Course, we cannot guarantee that all applicants will be accommodated. Applicants will be selected on first come first serve basis. The organizers will get in touch with you to confirm your spot. There is no fee for this course.
Email address *
Full Name *
Your answer
Primary Hospital/ Institution *
Your answer
City *
Your answer
Mobile Number *
Your answer
Years of Experience *
Which of the following surgeries do you most commonly perform? (>5 per month) *
Please select all that apply
Required
Primary Areas of Surgical Interest *
Please select all that apply
Required
Please share your motivation(s) for being a part of this course *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of InnAccel Technologies Pvt. Ltd.. Report Abuse - Terms of Service