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Seminar Application Form
Application for
Hybrid Coagulation Empowerment Network: Basic hemodynamics, hypoperfusion, coagulation activation and DIC
Istanbul, 29th April – 3rd May 2022
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Please upload your CV
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Professional Experience
Publication History
Please cite your most relevant professional publications here (maximum 5)
Please list 5 fields of special scientific or clinical interest from the list below. you may add your own
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Hematology
Obstetrics and gynaecology
General Anaesthesiology
Pediatric Anaesthesiology
Anemia
Cardiac Surgery
Hospital organisation and Workflow
Other…
other fields:
list your other fields here (one per line please)
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Case Presentation
Would you be willing to prepare, submit and Present a case Presentation (5 - 7 minutes) related the subject of the course medical field?
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no
Please select the medical field(s) to which your case presentation corresponds:
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Hematology
Obstetrics and gynaecology
General Anaesthesiology
Pediatric Anaesthesiology
Anemia
Cardiac Surgery
Hospital organisation and Workflow
Other…
field for case presentation
enter the subject here
Case Description
Please describe your clinical case study here. If you prefer to provide a file, please either upload it below send it to us by email at mailto:jgassner@gigajo.at
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Your Interest and Motivation
What motivates you to apply for this course?
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What do you expect to gain from participating in this course?
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How might you be able to contribute with your own background, skills and experience?
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