HeFSSA Heart Failure Management Meeting Bloemfontein
19 September 2026 | Protea Hotel, Willow Lake | 08:00 - 13:00
TERMS & CONDITIONS, INDEMNITY, AND CONSENT
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Meeting Registration
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Yes, I can attend (meeting is indicated for registered medical professionals)
Regret, I cannot attend
Title
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Dr
Prof
Assoc. Prof
Mr
Ms
First Name
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Surname
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Primary Affiliation (Hospital, University, Organisation, etc.)
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Eg. Netcare Milpark Hospital, Groote Schuur Hospital, University of Cape Town, etc.
E-mail Address
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example@example.com Please ensure this is correct as this address will be used to forward your CPD certificate
Mobile Number
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Specialty
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General Practitioner
Physician
Cardiology Fellow
Nurse
Pharmacist
Industry (Sponsoring Company)
Other
Medical Council Registration Number (Complete with Council abbreviation followed by number for example: MP 0123456, SANC 12345678, P 0123456, etc.)
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Type N/A if not applicable.
Practice Sector
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Private Sector
Public Sector
Private & Public Sector
City (Please indicate your city/town not your suburb. e.g. Bisho, Cape Town, George, Polokwane, Qonce, Soweto etc)
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Province
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Please Select
Not Applicable
Eastern Cape
Free State
Gauteng
KwaZulu-Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
Comments
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