Registration form

Personal information*

NameSurname

Fiscal code*

If not applicable, please digit 000

Affiliation*

Entity, Hospital, University

Contractual Form*

Selezionare un'opzione tra le voci proposte

Field*

Selezionare un'opzione tra le voci proposte

Please indicate if you have been recruited by a commercial company operating in the healthcare sector:*

A healthcare professional is considered to be recruited if he/she benefits from direct and indirect economic and non-economic advantages from commercial companies operating in the healthcare field for participation in training events,

Please indicate the company

Contact information*

E-mail addressPhone number

Special needs

Please indicate allergies, intolerances, special dietary needs or any other needs

Registration Fees*

Whole course - Physician - Fee reserved to AIOCC, AIRO, AOLPI, AOOI, AUORL, SIAPEC, SIOeChCF, SICMF, SIRM members

Fee valid until 15th June 2026. From 16th June 280,00 €

€240.00

Whole course - Physician

Fee valid until 15th June 2026. From 16th June 350,00 €

€300.00

Whole course - Resident - Fee reserved to AIOCC, AIRO, AOLPI, AOOI, AUORL, SIAPEC, SIOeChCF, SICMF, SIRM members

Fee valid until 15th June 2026. From 16th June 200,00 €

€160.00

Whole course - Resident

Fee valid until 15th June 2026. From 16th June 250,00 €

€200.00

Single module - Physician - Fee reserved to AIOCC, AIRO, AOLPI, AOOI, AUORL, SIAPEC, SIOeChCF, SICMF, SIRM members

Fee valid until 15th June 2026. From 16th June 120,00 €

€96.00

Single module - Physician

Fee valid until 15th June 2026. From 16th June 150,00 €

€120.00

Single module - Resident - Fee reserved to AIOCC, AIRO, AOLPI, AOOI, AUORL, SIAPEC, SIOeChCF, SICMF, SIRM members

Fee valid until 15th June 2026. From 16th June 88,00 €

€64.00

Single module - Resident

Fee valid until 15th June 2026. From 16th June 110,00 €

€80.00

Two modules - Physician - Fee reserved to AIOCC, AIRO, AOLPI, AOOI, AUORL, SIAPEC, SIOeChCF, SICMF, SIRM members

Fee valid until 15th June 2026. From 16th June 200,00 €

€176.00

Two modules - Physician

Fee valid until 15th June 2026. From 16th June 250,00 €

€220.00

Two modules - Resident - Fee reserved to AIOCC, AIRO, AOLPI, AOOI, AUORL, SIAPEC, SIOeChCF, SICMF, SIRM members

Fee valid until 15th June 2026. From 16th June 160,00 €

€120.00

Two modules - Resident

Fee valid until 15th June 2026. From 16th June 200,00 €

€150.00

Total

€0.00

Note

If chosen one or two modules, please indicate which ones you're interested in

Select the payment method:*

Bank transfer (the secretariat will send the details via e-mail)Online credit card (the secretariat will send a personal link via e-mail)

Invoicing information*

Header of the invoice

Fiscal address: street, town, postal code

Date and place of birthVAT number (if applicable)

Any notes