Advanced Phaco Study Day


I would like to apply to attend the Alcon Education Programme on

Friday 23rd April 2010

I understand that places are limited and, as such, no guarantee can be given at this stage that my application will be successful.  I also appreciate that courses may have to be cancelled at short notice due to circumstances beyond Alcon's control.

Note Fields marked with * are Mandatory

 

* Title

Under the ABHI Code of Business Practice, Alcon is required to inform your superior, hospital administration or designated competent authority (as appropriate), offering them the opportunity to comment on, approve or oppose your attendance. Please indicate below to whom you would like us to direct this correspondence to.

* Title

Phaco Equipment Used

 Phaco Power    Vacuum    Aspiration  

Which incision site do you prefer ?

* Approximately how many phaco procedures have you performed ?

**  Please note that all information will be treated in the strictest confidence and the correspondence address will only be used in relation to the Alcon Study Day.