[[[["field9","equal_to","Others"]],[["show_fields","field10"]],"and"]] 1 Step 1 Personal Information Name Surname Date of birthdate_range CountryCountryAFGANISTÁNALBANIAALEMANIAANDORRAANGOLAANTIGUA Y BARBUDAARABIA SAUDITAARGELIAARGENTINAARMENIAAUSTRALIAAUSTRIAAZERBAIYÁNBAHAMASBANGLADÉSBARBADOSBARÉINBÉLGICABELICEBENÍNBIELORRUSIABIRMANIABOLIVIABOSNIA Y HERZEGOVINABOTSUANABRASILBRUNÉIBULGARIABURKINA FASOBURUNDIBUTÁNCABO VERDECAMBOYACAMERÚNCANADÁCATARCHADCHILECHINACHIPRECIUDAD DEL VATICANOCOLOMBIACOMORASCOREA DEL NORTECOREA DEL SURCOSTA DE MARFILCOSTA RICACROACIACUBADINAMARCADOMINICAECUADOREGIPTOEL SALVADOREMIRATOS ÁRABES UNIDOSERITREAESLOVAQUIAESLOVENIAESPAÑAESTADOS UNIDOSESTONIAETIOPÍAFILIPINASFINLANDIAFIYIFRANCIAGABÓNGAMBIAGEORGIAGHANAGRANADAGRECIAGUATEMALAGUYANAGUINEAGUINEA ECUATORIALGUINEA-BISÁUHAITÍHONDURASHUNGRÍAINDIAINDONESIAIRAKIRÁNIRLANDAISLANDIAISLAS MARSHALLISLAS SALOMÓNISRAELITALIAJAMAICAJAPÓNJORDANIAKAZAJISTÁNKENIAKIRGUISTÁNKIRIBATIKUWAITLAOSLESOTOLETONIALÍBANOLIBERIALIBIALIECHTENSTEINLITUANIALUXEMBURGOMADAGASCARMALASIAMALAUIMALDIVASMALÍMALTAMARRUECOSMAURICIOMAURITANIAMÉXICOMICRONESIAMOLDAVIAMÓNACOMONGOLIAMONTENEGROMOZAMBIQUENAMIBIANAURUNEPALNICARAGUANÍGERNIGERIANORUEGANUEVA ZELANDAOMÁNPAÍSES BAJOSPAKISTÁNPALAOSPANAMÁPAPÚA NUEVA GUINEAPARAGUAYPERÚPOLONIAPORTUGALREINO UNIDOREPÚBLICA CENTROAFRICANAREPÚBLICA CHECAREPÚBLICA DE MACEDONIAREPÚBLICA DEL CONGOREPÚBLICA DEMOCRÁTICA DEL CONGOREPÚBLICA DOMINICANAREPÚBLICA SUDAFRICANARUANDARUMANÍARUSIASAMOASAN CRISTÓBAL Y NIEVESSAN MARINOSAN VICENTE Y LAS GRANADINASSANTA LUCÍASANTO TOMÉ Y PRÍNCIPESENEGALSERBIASEYCHELLESSIERRA LEONASINGAPURSIRIASOMALIASOUTH AFRICASRI LANKASUAZILANDIASUDÁNSUDÁN DEL SURSUECIASUIZASURINAMTAILANDIATANZANIATAYIKISTÁNTIMOR ORIENTALTOGOTONGATRINIDAD Y TOBAGOTÚNEZTURKMENISTÁNTURQUÍATUVALUUCRANIAUGANDAURUGUAYUZBEKISTÁNVANUATUVENEZUELAVIETNAMYEMENYIBUTIZAMBIAZIMBABUE GenderFemaleMale Cityyour full name Geographical regionpick one!Geographical regionSouth AmericaCentral AmericaNorth AmericaCaribbeanEuropeAfricaAsiaOceania Emaila valid emailemail Additional Data Select your activitypick one!Select your activityI´m the head of an intensive care unit I´m the head of an respiratory unit I´m the head of the anesthesic department I’m an intensivist consultantI´m a pulmonologist consultantI´m a anesthesic consultantI´m a consultantI´m a medical studientI´m a nurseI´m a paramedicI´m a respiratory patient I´m not related to health careOthers ¿Which? ¿What is the name of your Hospital?your full name ¿How many beds does your hospital have?your full name ¿How many beds does your Intensive care unit?your full name ¿Your intensive care unit is¿Your intensive care unit is?Surgical MedicalCardiologicalTraumaBurn unitMedico-surgicalNeurosugicalGinecoobstetricalOthers ¿Do you have a PhD?YesNo ¿During the last 5 years, have you published?pick one!¿During the last 5 years, have you published?Yes, more than 5 articles in pubmedYes, between 1 to 4 articles in pubmedYes, but no in pubmedNo ¿Are you willing to participate in research studies?YesNo ¿How did you find out about "The World day of the critical lung?pick one!¿How did you find out about "The World day of the critical lung?Social media By my national scientific federation or societyI´ve received an email from the organizationInternet searchI don´t know or I don’t remember ¿Did you participate on the previous edition of the World Day of the critical Lung?YesNo ¿How are you going to participate in the event?pick one!¿How are you going to participate in the event?By streaming. Please, send me the event´s link I will go to Universitary Hospital HM Sanchinarro-Madrid-SpainI will go to INSIMED- Bogota- ColombiaI will go to Fundación Universitaria del Área Andina seccional Pereira - ColombiaI will go to the "Eugenio Espejo" Hospital in Quito-EcuadorI will go to Medicina Critica, San Felipe, Yaracuy - VenezuelaI will go to Raoul Follereau Hospital - Guinea BisauI will go to the Hospital "Zambrano Hellion- Technical Institute of Monterrey" - MexicoI will go to "Hospital del Carmen. Unidad de terapia intensiva. Mendoza, Argentine"I will go to "Hospital de Especialidades Carlos Andrade Marín" . Quito- Ecuador.I have not decided yet Register keyboard_arrow_leftPrevious Nextkeyboard_arrow_right FormCraft - WordPress form builder
