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

HCC Forum - Bologna

October 19, 2018 | Bologna, Italy

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Personal Details

First Name: *

Last Name: *

Medical Center/Hospital/Company: *

Are you employed by a hospital-based or 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: *

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

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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
    	    
Fellow or Resident*
    	    
Industry or Non-clinical

COUNTRY OF PROFESSIONAL LICENSURE: *

COUNTRY 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 *

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

1
2
3
4
5

What is your biggest challenge in treating HCC patients?

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

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?

How many physicians in your group engage in interventional oncology?

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 years have you been treating oncology patients?

1-5
6-10
11-15

How many years have you been in practice?

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

What is your specialty focus?

Interventional Radiology
Oncology
Hepatology
Transplant or Hepatic Surgery

Discount Code

Registration Fees

Fee Description TOTAL
Registration Fee:
None
Total Due: