DSATC registration

Definitive Surgical and Anaesthetic Trauma Care Course 2022

I would like to register for course A on 8 & 9 November 2022 as:

Anaesthesiologist/intensivist (DATC) - €2225,- (3/20)

Anaesthesiologist/intensivist (DATC) - I already paid for previous course (0/1)

OR-Nurse - €500,- (0/9)

Nurse Anesthetist - €500,- (1/2)

I would like to register for course B on 10 & 11 November 2022 as:

Anaesthesiologist/intensivist (DATC) - €2225,- (2/20)

Anaesthesiologist/intensivist (DATC) - I already paid for previous course (0/1)

OR-Nurse - €500,- (0/9)

Nurse Anesthesist - €500,- (0/2)

If other, please fill here:

Position

AIOS

Medical specialist

Other/ not applicable

Nurse

Medical specialism *

Anaesthesiology

Intensive care

Other/ not applicable

Experience in trauma cases *

Less than 10 cases

Between 10-30 cases

More than 30 cases

Other/ not applicable

Dhr/Mw *

Titel

Voornaam *

Achternaam *

Land *

Postcode *

Huisnummer *

Straat *

Plaats *

Date of birth: *

E-mailadres *

Function

Organisation

Z-number (only for Radboudumc employees)

BIG nr. (in case you do not have a BIG nr please fill in zero) *

Food Allergy or Dietary Wishes

I agree with the general terms and conditions *

Totaal: € 0,00

Registration Form