Registration

Registration form

Your greeting (mr, mrs, dr, prof etc.)

Your First name (required)

Your Last name (required)

Your Place of work

Your Country and city (required)

Your e-mail (required)

Registration type (required)

Are you a member of Russian Professional Medical Association of Complementary and Alternative Medicine or European Society of Integrative Medicine (ESIM-Berlin)?
YesNo

Are you a member of World Hirudotherapy Organization?
YesNo

Number of seats at Congress Dinner? (Included in VIP ticket – don’t order here)

Number of seats on bus tour? (Included in VIP ticket – don’t order here)

Additional notes:

I confirm, that the information which I have submitted in latin script above is correct.