First Name * Last Name * Email * National Society * - Select -Algerian Society of Internal MedicineArgentinian Society of Internal MedicineAustrian Society of Internal MedicineBelgian Society of Internal MedicineCypriot Society of Internal MedicineCzech Society of Internal MedicineEuropean Federation of Internal MedicineEuropean Journal of Internal MedicineEuropean Journal of Case Reports in Internal MedicineEstonian Society of Internal MedicineFinnish Society of Internal MedicineFrench Society of Internal MedicineGerman Society of Internal MedicineInternal Medicine Society of Northern GreeceIcelandic Society of Internal MedicineIsraeli Society of Internal MedicineItalian Society of Internal MedicineItalian Federation of Associations of Hospital InternistsLatvian Society of Internal MedicineLebanese Society of Internal MedicineLithuanian Society of Internal MedicineAssociation of Physicians of MaltaMoroccan Society of Internal MedicineMacedonian Association of Internal MedicineNetherlands Society of Internal MedicineNorwegian Society of Internal MedicinePolish Society of Internal MedicinePortuguese Society of Internal MedicineRomanian Society of Internal MedicineRussian Scientific Society of Internal MedicineSerbian Association of Internal MedicineSlovak Society of Internal MedicineSlovenian Society of Internal MedicineSpanish Society of Internal MedicineSwedish Society of Internal MedicineSwiss Society of General Internal MedicineTunisian Society of Internal MedicineTurkish Society of Internal Medicine Royal Colleges of Physicians UKSociety for Acute Medicine UK Country * - Select -AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong Kong S.A.R., ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe contact number * 3227259424 Position in National Society * Will you attend the 5th EFIM Day in Brussels * Yes No Will you attend the meetings of EFIM Working Groups? * - Select -YesNo Please select the WG meeting you will attend? * - Select -NoneChoosing WiselyProfessional Issues & Quality of CareGender MedicineUltrasound Will you attend EFIM Dinner on 14th of March? * Yes No If you will be accompanied, please state the name of your guest
