Ultrasound Guided Regional Anesthesia

Toronto Western Hospital Visit Program

University of Toronto

I. Registration Personal Data Please complete all the fields marked with * Title * First Name * Last Name Clinic/Department/Organization * Full Address City State/Province Country Postal/Zip Code Telephone Telefax * E-mail * Special Meal Requirement Please check off the fields that apply to you : Anesthesiologist Neurologist Neurosurgeon Psychiatrist Psychologist PMR RN NP PA Others How did you hear about our workshop: Colleague Website E-Mail Others *Machine Requirement (BK Medical, GE, Philips, SonoSite) BK Medical GE Philips II. Registration Fee Workshops Available Dates for 2012 Please select date September 28-30, 2012

back