Delegate Registration Form

The European Centre for Connected Health, DHSSPS is hosting an exciting full-day event on Wednesday 7th May at which companies involved in innovative healthcare-related technology will be given the opportunity to showcase their products and services to commissioners, providers and clinicians responsible for health and social care services in Northern Ireland.

Please complete the following form then click “Submit Form Details” to process the registration.

Please Note: There is no charge for registration.

Tel: ++44 (0) 28 9066 4020 Fax: ++44 (0) 28 9038 1257 e-mail: jaime@happen.co.uk.

Delegate Details
	Fields marked with an asterisk ( * ) must be completed!
Title:*	(Mr/Mrs/Ms/Dr/Prof etc)
First Name:*
Surname:*
Organisation:*
Contact Telephone:	(Please include country code)
Email:*
Arrival Time:	Morning Afternoon

Other Comments

Please indicate below any additional comments that may help us process your application.

  

European Connected Health Expo Day :: Remada Hotel, Belfast :: Wednesday 7th May