Fresenius

Event Registration

Contact Information

*First Name:

*Last Name:

Middle Name:

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*Email:

*Phone Number:

Mobile Phone Number:

By providing your mobile number, you agree to receive a text reminder for this program. Standard text message rates may apply.

Professional Information

*Registrant Type:

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*Job Title:

*Specialty:

NPI Number:

*Affiliation/Company:

State of License Number:

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State License Number:

*Address1:

*City:

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Address2:

*ZIP Code:

Fax Number:

By checking this box, you are opting in to receive emails from Fresenius Kabi. This will allow us to digitally communicate with you via emails, which might contain newsletters, product information and updates. You may withdraw your consent at any time by clicking the “unsubscribe” link in our emails.

By registering to attend this event, you are authorizing to providing your data to Fresenius Kabi. Fresenius Kabi will use this data to facilitate compliance with all Federal and State laws requiring disclosure of remuneration attributable to healthcare professionals attending this event. Fresenius Kabi will aggregate meeting expenses and allocate a portion equally among all attendees, when applicable.

Fresenius Kabi complies with the PhRMA Code on Interactions with Healthcare Professionals; therefore, spouses, partners, or other guests are not permitted to attend any meeting or social function. Continuing Medical Education (CME) credits are not available for attendance at this program.

HCPs from the states of Vermont and officials or employee of federal or state agencies or state employees, are strictly prohibited by law from accepting food items or meals of any kind, regardless of value, during this event. Additionally, in accordance with Minnesota law, Fresenius Kabi may not provide meals that total in aggregate more than $50.00 per year to any HCP who resides or practices in Minnesota.

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Contact Information

Professional Information

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