All information inputted should be in English 输入的所有信息均应为英文
*required *要求
Email 电子邮箱
First Name 名字
Last Name 姓
Job Title 职位
Department 所在部门 C-level 高层 Clinician/Medical 临床医生/医疗人员 Customer Service 客户服务 Finance 金融 HR/Training 人力资源/培训 IT/Transformation IT /转型 Marketing/Sales 市场销售 Nursing 护理学 Operations 运作方式 Patient Experience 病人经验 Patient Safety 病人安全 Quality / Excellence 品质/卓越 Others 其他
Company / Hospital 公司/医院名称
Company activity (choose from the following) 公司业务类型(从以下选项中选择) Academic Institution 学术机构 Healthcare provider (hospitals/clinics) 医院 / 诊所 Government Agency 政府机构 Investor 投资者 Solutions provider 解决方案提供商 Hospital association / 医院协会 Others / 其他
Phone 电话号码
Mobile 手机号码
Address 地址
Post code 邮编
Town/City 城镇/城市
Country 国家 Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire sint eustatius and saba Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Holy See (vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French Part) Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Sint Maartin (Dutch Part) Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands United States of America Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Type of hospital 医院类型 Public 公立Private 私人
Number of hospital beds 病床数
How did you hear about the event? 您如何得知该会议? Word of mouth 口口相传Search engine (Google, Baidu, etc.) 搜索引擎(Google,百度等)Hospital Association 医院协会Social Media 社交媒体Print/Online media 印刷/在线媒体Email from organiser 来自主办方电子邮件Call from organiser 来自主办方的电话
Subscribe to Hospital Management Asia HMA通讯 Yes, I would like to receive Hospital Management Asia newsletter - a bi-weekly online publication for the hospital management community. 我想订阅HMA新闻通讯,以接收有关最新医疗保健行业的最新消息以及对医疗保健领导者的独家采访。
Business Communication Info 商务交流信息 I confirm that the contact information I have given is for the purpose of business communications* 我确认我提供的联系信息是用于商务交流
Privacy Policy 隐私政策 I confirm that I have read and agree to the Privacy Policy. 我已阅读并同意隐私政策
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