MARLIN workshop registration form

MARLIN workshop registration form

SAMIRA Study on reporting and learning from patient-related incidents and near misses in radiotherapy, interventional cardiology, nuclear medicine and interventional and diagnostic radiology
A free workshop for interested parties from national competent authorities, national health authorities, European and national professional societies, European and international bodies, patient representatives, industry, individual experts and more.

This project has received funding from the European Commission under Service Contract N°ENER/2022/NUCL/SI2.880751.
September 5 & 6, 2024, BluePoint Brussels, Belgium

September 5 (13:00-17:30) September 6 (09:00-16:30)
Title
Name*

First NameLast Name
Email*
Your country*
If "other," please enter your country
Capacity in which I will attend the workshop*
If "other," please provide details
Affiliation (how you wish your affiliation to be listed in the attendance list)*
Thursday, September 5 (13:00-17:30)Friday, September 6 (09:00-16:30)
Please list any allergies or dietary requirements
Please provide any comments for the organisers ahead of the workshop
I agree
Privacy Statement: By submitting this registration form, I agree that my personal data will be electronically processed for the purpose of organising the event. I agree that my contact details will be shared with cooperating partners if required for the purpose of organising the event. I agree that live web streaming, video recording and images of the speakers and participants, as well as photographs of groups of participants and organisers, may be taken and published in the context of the workshop*

I acknowledge
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MARLIN workshop registration form

September 5 & 6, 2024, BluePoint Brussels, Belgium