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

Accept terms and conditions*

For any image, footage, text, audio, or any other content that you upload, you represent and warrant that: (i) I hereby declare that all the information contained in, and attached to, the present form is correct to the best of my knowledge and truthful, (ii) you have all necessary rights to submit Your Content and grant the licenses set forth herein; (iii) WCPH will not need to obtain licenses from any third party or pay royalties to any third party with respect to Your Content; (iv) Your Content does not infringe any third party's rights, including intellectual property rights and privacy rights; and (v) Your Content complies with all applicable laws.*

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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