Welcome to Mylan Symposium on Dyslipidaemia management, Monday, October 5
th
6.30 - 8:00 PM CET
Add to calendar
CONSENT FORM
All fields marked with an asterisk (
*
) are mandatory
Country
*
-- Please Select --
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTIGUA & BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELGIUM
BELIZE
BENIN, PEOPLES REPUBLIC OF
BERMUDA
BHUTAN
BOLIVIA
BOSNIA AND HERZEGOVINA
BOTSWANA
BRAZIL
BRITISH VIRGIN ISLANDS
BRUNEI
BULGARIA
BURKINA FASO
BURMA (MYANMAR)
BURUNDI
BYELORUSSIA
CAMEROON
CANADA
CAPE VERDE, REPUBLIC OF
CAYMAN ISLANDS
CENTRAL AFRICA REPUBLIC
CHAD, REPUBLIC OF
CHILE
CHINA, PEOPLES REPUBLIC OF
CHRISTMAS ISLAND
COLOMBIA
COMOROS REPUBLIC
CONGO DEMOCRATIC REPUBLIC
COOK ISLANDS
COSTA RICA
CROATIA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FAERO ISLANDS
FALKLAND ISLANDS
FIJI
FINLAND
FRANCE
FRENCH POLYNESIA/TAHITI
GABON REPUBLIC
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUAM
GUATEMALA
GUINEA BISSAU
GUINEA REPUBLIC OF
GUYANA
HAITI
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN
IRAQ
IRELAND
ISRAEL
ITALY
IVORY COAST/COTE D'IVOIRE
JAMAICA
JAPAN
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA, REPUBLIC OF
KUWAIT
KYRGYZSTAN
LATVIA
LEBANON
LESOTHO
LIBERIA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAU
MACEDONIA
MADAGASCAR
MALAYSIA
MALDIVES
MALI
MALTA
MARIANAS ISLANDS
MARSHALL ISLANDS
MAURITANIA
MAURITIUS
MEXICO
MOLDOVA
MONACO
MONTSERRAT
MOROCCO
MOZAMBIQUE
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NORFOLK ISLAND
NORWAY
OMAN
PAKISTAN
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
POLAND
PORTUGAL
QATAR
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT HELENA
SAINT KITTS - NEVIS
SAINT LUCIA
SAINT VINCENT
SAN MARINO
SAO TOME - PRINCIPE
SAUDI ARABIA
SENEGAL
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA
SPAIN
SRI LANKA
SUDAN
SURINAME
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN (REPUBLIC OF CHINA)
TAJHIKSTAN
TANZANIA
THAILAND
TOGO
TOKELAU ISLANDS
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES OF AMERICA
URUGUAY
UZBEKISTAN
VANUATU
VENEZUELA
VIETNAM
WESTERN SAMOA
YEMEN
ZAIRE
ZAMBIA
First Name
*
Last Name
*
Email Address
*
Speciality
*
-- Please select one --
Cardiology and vascular diseases
Cellular Therapy
Clinical Research Associate
Emergency Medicine
General Medicine
Geriatrics
Haematology
Haematology (Blood disease option)
Haematology (Onco haematology option)
Intensive Care Medicine
Internal Medicine
Internal Medicine and Clinical Immmunology
Medical Biology
Medical Research
Multi-purpose pharmacy and hospital pharmacy
Nurse (State Registered Nurse)
Oncology (Onco haematology option)
Oncology medical option
Oncology radiotherapy option
Pharmacy
Public Health and Social Medicine
Qualified in General Medicine
Specialist in General Medicine
Other
Yes, I have read the
data protection notice
and agree that Mylan (see company information in data protection notice) uses my business contact data to provide me with scientific information and information on pharmaceutical products as well as events, webinars or surveys of Mylan group. In order to improve its emails, websites and information services, Mylan may track whether I received an email, opened it,clicked on any links, viewed or downloaded any documents in it. My consent is voluntary. I can withdraw my consent at any time. The withdrawal of consent will not affect the lawfulness of processing based on consent before its withdrawal.
*
Submit