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First name
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Last name
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Email
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Organisation
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*How would you like an internship? If you want practice in a specific department Priority 1 (Land or department):
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Priority 2 (Land or department):
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*Priority 3 (Land or department):
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*What is your experience with endoscopy? Please write how many procedures you performed:
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*Gastroscopy?
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Colonoscopy?
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*ERCP?
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*EUS?
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*What are your expectations for the stay? (Training?, you would like to see?):
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*What are your expectations for the stay? (Special procedures you would like to see?):
Would like to attend with following colleague:
Pls. confirm that you have made your Hands-on registration and your payment
I have made my registration
I have paid my registration
none of above
Anything we should know?
SUBMIT
Hands-on/Observation Questionary - 15+16. January 2024
Time is TBD
Location is TBD
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