OMEGA : Registration Form

Doctor’s Name:*
Gender:	Male Female Other
Mobile Number:*
Any other contact No:
Email (Frequently Used):*
Qualification:*
Do you have access to any of the lung oscillometry device:	Yes No If yes, Please Specify:
Is this your first workshop on Lung Oscillometry techniques:	Yes No
Would you like to recommend lung oscillometry training programs for other physicians?	Yes No
Address:*
How did you know about OMEGA:

I hereby give consent to receiving further communication from ARISE for academic and research purpose: Yes No

(Kindly check your spam folder for registration confirmation email, if not seen in the inbox.)

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