Complete Conference Management, a division of UMA Education, Inc.

HCC Forum - New York

April 13, 2018 | Intercontinental New York Times Square | 300 W 44th Street | New York, NY 10036

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Personal Details

First Name: *

Last Name: *

Medical Center/Hospital/Institution: *

Are you employed by a hospital-based or a private practice?:*(Please select one)

Hospital-Based Practice Private Practice

title *

Designations: * (Select up to two degrees)

Hold the Ctrl key while selecting additional degree.

Preferred Mailing Address 1: *

Preferred Mailing Address 2:

City: *

State: *

Zip: *

Primary Email: *(Format: email@domain.com)

Telephone (Day): *(Format: XXX-XXX-XXXX)

Mobile Phone: *(Format: XXX-XXX-XXXX)

Country: *

Confirm Primary Email: *(Format: email@domain.com)

Secondary Email: (Format: email@domain.com)

Confirm Secondary Email: (Format: email@domain.com)

CONFIRMATION INFORMATION WILL BE SENT TO YOUR PRIMARY AND SECONDARY EMAIL ADDRESSES.
CERTIFICATE INFORMATION WILL BE SENT TO YOUR PRIMARY EMAIL.

Professional Information

Select a Profession:*(Please select one)

    	    
Physician
    	    
Industry/Non-clinical

US STATE OF PROFESSIONAL LICENSURE: *

US STATE OF PROFESSIONAL LICENSURE 2:

License #:What is this

SPECIAL SERVICES (ADA):What is this

More Information

WHAT CONTRIBUTED MOST TO YOUR decision TO REGISTER? *

Age Group *

What is your specialty focus?

Interventional Radiology
Oncology
Hepatology
Transplant or Hepatic Surgery

How many years have you been in practice?

1-5
6-10
11-15
16-20
More than 20

How many years have you been treating oncology patients?

1-5
6-10
11-15

How many HCC patients do you treat in a year?

5-10
11-20
21-30
31-40
More than 40

How many physicians in your group engage in interventional oncology

1-5
6-10
11-15

Do you participate in Tumor Boards or case reviews with the other specialists treating HCC in your hospital?

Yes
No
My hospital does not have a tumor board

If you do not participate in a Tumor Board, why not?

What is your biggest challenge in treating HCC patients?

Getting access/referred to see the patients
Working with the other specialists involved

On a scale of one to five, with one being the lowest and five bieng the highest, what is your comfort level in communicating with other specialists regarding HCC patients?

1
2
3
4
5

Discount Code

Registration Fees

Fee Description TOTAL
Registration Fee:
None
Total Due: