Workshop Inscriptions

MútuaTerrassa University Hospital Pelvic Floor Unit of the Gynecology Service

To formalize the registration, please fill in the form below and make a bank transfer to: ES37-2100-0087-6002-0047-4549

We remind you that you have to specify in the transfer details your name, surname and reference number 55400.15

The purpose of this form is to formalize the training request. Your personal data will be used only for the registration process and confirmation:

Name and surname

Phone

Department

Hospital

Observations