Pre-registration - La codification des actes en dermatologie-vénéréologie

Individual/self-employed Company

Session *

Name of the individual *

First name of the individual *

Email of the individual *

Phone *

Address of the individual *

City *

Postcode *

Country *

Date of birth of the individual *

Session *

Company name *

Company email *

Phone *

Company registration number *

Company address *

Company address (city) *

Company address (postcode) *

Company address (country) *

The data collected in this form are processed by AFORSPE to manage your pre-registration on the site. To find out more about the management of your personal data and to exercise your rights, we invite you to read our Privacy Policy