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Registration form for practitioners

Specify you specialization* *

State the topics you are interested in:

Vascular surgery
KemAngioprotez
KemPeriplas-Neo
Cardiac surgery
Heart valve bioprostheses
Aortic valve
TiAra
UniLine (aortic)
Mitral valve
UniLine (mitral)
Tricuspid valve
Tricuspid ring
Ross procedure

Surname, first name, patronymic *

Password for registration at the site *

E-mail *

Phone *

Name of medical and preventive treatment institution

Consent to processing of personal data *

I give my consent for processing of my personal data in accordance with the provisions of the User Agreement.

Notes

Healthcare Professionals

Cardiac surgery
Vascular surgery
- Lower Limb Arteries
- Carotid Artery

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