Apply to Join the European FA Virtual Tumor Advisory Board

Please enable JavaScript in your browser to complete this form.

Email Europe) Prof,

Please complete, sign and submit this form.

Title (e.g. Prof, Dr, Mrs)

Name

First

Last

Area of Expertise

Hospital or Research Establishment

Country (Must be in Europe)

Confidentiality Agreement

Please read the following agreement and sign below, using a mouse or touchscreen.

I consent that I will participate with my expertise in the Virtual Tumor Advisory Board organized by FA Europe. I agree to maintain the confidentiality of all pseudonymized medical data presented during the meetings and will not store, share, or disclose this information in any form. I will not record the meeting. Furthermore, I commit not to attempt to identify any patient based on the information provided.

Initials or Signature (press x to clear box and re-sign)

Clear Signature

Date

Apply to Join the European FA Virtual Tumor Advisory Board

Confidentiality Agreement

Sign-up for Updates

Join our mailing list and we’ll keep you updated with our work, special events and ways in which you can make a difference. Your email will not be shared.