First and last name
CUIM certificate issued by the Romanian (or your national/official) College of Physicians
Email
Phone
Town/City
Workplace
Professional degree
Specialty
Medical unit
Street address
In order to apply the provisions of the new Regulation, the Functional Medicine Association needs your consent to process certain personal data. You agree to the use of your personal data for communication methods, for the purpose of scientific and commercial information. DO YOU AGREE with the use of your e-mail address for correspondence, communication, scientific and commercial information?
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