CONGRESS OF PHARMACOECONOMICS AND OUTCOMES RESEARCH

For accomodation information please do not hesitate to contact us at tatjana.koprtla@otours.hr

(please complete all fields - all fields are required)

Title

First Name

Family Name

I accept that professional Congress organizer sends me other non-promotional announcements and information related to healthcare

YES NO

Post Address

Post Code

City

County

Mobile phone number

Employed at

On A Position Of

Employer Category

Registration Fee

€ tax excluded

Arrival Date

Departure Date

Registration/accomodation

Total

€ tax included (25%)

Full name of the 2nd person in the room

Special requirements / message to congress organizers

Safety code: