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Registration MedPeers event - 30 October 2026

E-mail

*

First name

*

Last name

*

Hospital

*

Department

*

BIG-nummer (voor accredidatie)

Gewenste accredidatie

NVvR

NVvC

Do you want to participate in the MedPeers Clot Catcher Challenge?

*

A

Yes

B

No

I give permission for photos and videos to be taken at this event to use for promotional purposes:

*

A

Yes

B

No

I give MedPeers permission to contact me via email for communication purposes related to this and other MedPeers events:

*

A

Yes

B

No

Allergies and/or diet preferences

Function selection for registration fee

*

A

Medical specialist

B

Resident in training

C

Technician/Scientist

D

Nurse/Laborant

E

PhD student

F

Medical student

G

Speaker