HeFSSA Heart Failure Management Meeting Richards Bay

HeFSSA Heart Failure Management Meeting Richards Bay

3 June 2023 | Premier Hotel The Richard's | 08:30 - 13:30
CONSENT: I understand the purpose for disclosing this personal information. Collection of this information complies with The Protection of Personal Information Act 4 of 2013 (POPI), South Africa. If you have any questions about the Privacy Policy contact info@hefssa.org*

YesNo
Please note: Consent is needed to register for this meeting.
Meeting Registration*

Yes, I can attendRegret, I cannot attend
Confirmation*

I confirm: I am a registered professional in healthcare, or related fields. I will attend this meeting 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.
Delegate Information*

TitleFirst NameSurname
E-mail Address*
example@example.com Please ensure this is correct as this address will be used to forward your CPD certificate
Mobile Number*
Specialty*

General PractitionerPhysicianCardiology FellowNursePharmacistIndustry (Sponsoring Company)
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*
Type N/A if not applicable.
Practice Sector*

Private SectorPublic SectorPrivate & Public Sector
City (Please indicate your city/town not your suburb. e.g. Bisho, Cape Town, George, Polokwane, Qonce, Soweto etc)*
Province*
Dietary Requirements

Kindly take note: Menu is no pork, vegetarian friendly, with a fish option available.
Food Allergies*
Please Specify. Type N/A if not applicable.
This meeting is only indicated for registered professionals in healthcare and related disciplines.
HeFSSA acknowledges with appreciation Corporate Support from:
Should be Empty: