home

Aifa Accreditation Form

We kindly ask you to fill in the below form as the Italian Drug Agency requires the abstract presenter personal information to evaluate the importance and relevant of the scientific program of the congress












Type of abstract

WorkshopOralPoster

In case of workshop, please insert all personal details of all the speakers/moderators involved in the workshop










Speakers 1










Speakers 2










Speakers 3










Speakers 4










In case you have presented a Case Study or Case History please write a brief description of the Case, including gender and age of the patient, therapy used (surgery, pharmacological), if pharmacological please specify the active substance (no commercial name).



In case you have used acronymous please write a legend


Copyright © 2020 Wcph2020. All Rights Reserved.Designed by Triumph Group International