SEUD 2023

Family name*

First name*

E-mail address*

Cell phone number*

Cell phone number (only) Please indicate in front of your phone number, the country dialling code of your country.

Affiliated Medical Center*

Country*

City*

EVALUATION

Have you submitted an abstract into our platform?*

TITLE OF THE ABSTRACT*

What is your professional activity/position?*

Where do you hold your primary professional activity?*

Primary professional activity center*

Which is your main field of interest?*

How would you define yourself?*

Do you want to participate to one of the Pre-Congress Course*

Pre-Congress Courses*

Pre-Congress Course : AUB
Pre-Congress Course : INFERTILITY
Pre-Congress Course : IMAGING
Pre-Congress Course : Chronic Pelvic Pain in Women : Manual and Physical management

Gala dinner*

65€/person. 8:30 PM. Place to be confirmed.

INVOICE ADDRESS

Email

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