Digital implantology from micro to macro form

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Digital implantology from micro to macro form

APPLICATION FORM

Dear Doctor,
Thank you for your interest in our DIGITAL IMPLANTOLOGY FROM MICRO TO MACRO – Planning and execution of single to full arch immediate loading restauration cours.

In order to process your registration and find a place in our programme that perfectly suits your needs, we kindly ask you to provide the following information about your personal and professional status.

After applying, you will shortly receive a response from us with all the information you need in order to proceed with your registration.

Best regards,
Assoc. Prof. Dr. Dr. Cristian Dinu
MD, DMD, MSc, PhD • Consultant in Oral and Maxillofacial Surgery Programme Director

*required fields Personal information:

Full Name *

Email Address *

Telephone *

Address *

Postcode *

City *

Personal information:

Graduation University *

Year Of Gratuation *

Specialty / Fields Of Interest:
Surgical Implantology
Restorative Implantology
Periodontology
Orthodontics
Workplace:
Private
Institutional
Workplace *

What are your expectations from this course?

I agree to the processing of my personal data in order to place the order and optional account creation, if the option has been selected. The basis of the processing is the contractual obligation, for the purpose of delivery of the ordered products, the duration of the processing being the period of the limitation period of 3 years from the placement order. To the extent that you do not agree with the processing of your data, we inform you that we will not be able to deliver the products ordered. Your rights as a data subject are guaranteed by Privacy policy.
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