Simovision | Event Subscription Form

Simovision event subscription module

By filling out this form, you confirm being an Ophthalmologist or Medical Professional active in Benelux.

Event:

Please select the Event you wish to attend.

First name:

Please enter your First Name.

Last name:

Please enter your Last Name.

E-mail address:

Please enter your E-mail address.

Name of Private practice:

Please enter the name of the practice you work at.

Years of experience:

Please indicate how many years of experience you have being an Optometrist.

Universitary hospital:

Dinner:

Dietary restrictions:

Please indicate when applicable.

VAT Number:

Please type in your VAT Number when applicable.

Overnight stay:

Preferred channel(s) to receive updates about trainings, events, products and innovations?

Privacy policy*:

* While using this Subscription Tool, you agree to the Privacy Policy Terms on our Website (which can be consulted in Dutch or in French).