Pre-registration of a learner

ACCOMPAGNER LA PRISE EN CHARGE PALLIATIVE DE LA PERSONNE ÂGÉE - the November 8, 2023

Vous pouvez préinscrire un apprenant à la formation grâce à ce formulaire. Merci de rentrer un maximum d'informations pour simplifier le travail d'enregistrement. Vous pouvez laisser un message complémentaire dans la partie 'Notes libres'.

General information

Honorific

First name*

Last name* Email* Phone

Language in the Learners' Portal

Status

Company*

Profession*

DPC fields

ADELI NO.

RPPS NO.

Main exercise (> 50%)*

Other

Free notes

Fields marked with * are mandatory.

The data collected in this form is processed by Promotion Santé Guadeloupe Saint-Martin Saint-Barthélemy in order to manage your registration on the site. To find out more about the management of your personal data and to exercise your rights, we invite you to read our privacy policy