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.