Yes, I can attend
Regret, I can not attend
I Confirm: I am a registered professional in healthcare, or related disciplines. I will attend this webinar in my professional capacity. I am not employed by a Medical Device or Pharmaceutical Company (except for the sponsoring company). All provided information is true and correct.
firstname.lastname@example.org Please ensure this is correct as this address will be used to forward your CPD certificate
Specialist Physician / Internist
Medical Council Registration Number (Complete with Council abbreviation followed by number for example: MP 0123456, SANC 12345678, P 0123456, etc.)
Type N/A if not applicable.
Primary Hospital Affiliation
Private and Public Sector
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