Service Module Consensus Conference 2026 Endohepatology

Service Module • Consensus Conference 2026 • Endohepatology

Conference Centre - Domina Zagarella Sicily HotelSanta Flavia (PA) 28- 30 May 2026

Name*

First

Last

Phone*

Email*

HOTEL ACCOMMODATION CONFIRMATION *

1 - DUS ROOM – Arrival on May 28, 2026, Departure on May 30, 2025 (2 nights)

NOTES

PARTICIPATION AT SOCIAL DINNERS*

May 28, 2026, Dinner

May 29, 2026, Dinner

I will not attend

Food allergies or intolerances (write NONE if you have not)*

Trip*

I will provide by myself to arrange my trip - N.B. After booking your flights, please send a copy of your personal tickets to segreteria@promeeform.it by the 10th of April, so that transportation can be arranged in good time. For European flights, the maximum reimbursable amount is €500.00. For intercontinental flights, the maximum reimbursable amount is €1,500.00. Refunds will be processed within 90 days after the end of the Conference. The Organizing Secretariat will reimburse only the cost of your own airline tickets. Tickets for companions are not eligible for reimbursement. Taxi, train, or other transportation expenses will not be reimbursed.

Pursuant to EU Regulation 2016/679 (GDPR), I authorize the Promeeform srls (Organizing Secretariat) to process my personal data exclusively for purposes related to the organization and management of the above-mentioned event.

Please attach your Passport or Identity Document with your details (FRONT)*

Please attach your Passport or Identity Document with your details (REAR)

Date