Registration of Visual Rehabilitation Operators on this website

Application form for Registration of Visual Rehabilitation Operators of the Low Vision Academy on this website.

Enter the access code that you purchased at the secretariat of the conference and fill in the entire application form.
Inclusion of your details is voluntary and authorises their publication on the network.

Passcode
(one provided by the Low Vision Academy)


First name

Last name

Profession

Name of Centre that you belong to
(For example Low Vision Studies Centre)

City+County
(of the Centre that you belong to)

Prov.
(of the Centre that you belong to)

Region
(of the Centre that you belong to)

Title
(in the Centre that you belong to: for example. Ophthalmologist manager, rehabilitator, Optical Technician)

Work number (phone)

Email address


Special services offered to low vision patients


Courses attended at Low Vision Academy (how many and which ones)

Enter the date and title of attendance (example: Not Ipovisione Research1, but: 2014: Ipovisione e rigenerazione retinica. - Not Corso 2 AUSILI, but: 2014: Dall'acuità visiva alla scelta dell'ausilio per lontano e per vicino.



Privacy Policy:
Vi informiamo che i dati forniti saranno trattati ai sensi del Codice in Materia di Protezione Dati Personali (D. legisl. 30 giugno 2003, n. 196) e non verranno ceduti a terzi. IscrivendoVi al Registro degli Operatori su questo sito, dichiarate di prestare il Vs. consenso al trattamento dei Vs. dati personali.