preliminary programcongresos-medicos.com/docs/15267/icad2013_preprog.pdf · hair transplant...

8
PRELIMINARY PROGRAM

Upload: others

Post on 18-Jun-2020

3 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: PRELIMINARY PROGRAMcongresos-medicos.com/docs/15267/icad2013_preprog.pdf · HaiR TRanSPlanT •Causes of premature Hair loss in men, women and adolescent •Medical treatments to

PRELIMINARY PROGRAM

Page 2: PRELIMINARY PROGRAMcongresos-medicos.com/docs/15267/icad2013_preprog.pdf · HaiR TRanSPlanT •Causes of premature Hair loss in men, women and adolescent •Medical treatments to

Dear Colleagues,

The ICAD 2013 intends to become the congress where physicians will be introduced to the latest techniques and knowledge in Anti-Aging and Aesthetic medicine, and attend high standard courses in the respective fields of these specialties.

We have prepared a scientific program that proposes the diversity of various disciplines with the scientific approach combining hot topics with timely reviews presented by outstanding plenary speakers and offering the point of view from different continents.

Moreover, the scientific program has been carefully designed to be highly PRACTICAL and interactive. Most of presentations will effectively correspond to an application in daily practice. A series of workshops on the latest developments in their respective fields will be waiting for your participation.

This Congress is therefore not one to be missed. Come and benefit from the wisdom and experience of internationally reputed speakers. It will be an investment well spent and a once-in-a-lifetime learning experience.

So please do avail yourselves of this stimulating and enjoyable opportunity.

The Scientific Committee

Preya KULLAVANIJAYA, MD Honorary PresidentNopadon NOPPAKUN, MD, Assoc. Prof. Honorary PresidentKrisada DUANG-URAI, MD PresidentNatta RAJATANAVIN, MD, Assoc. Prof. Vice-PresidentKanokvalai KULTHANAN, MD, Prof. Secretary-GeneralPravit ASAWANONDA, MD, PhD, Prof. Scientific (Aesthetics)Apirag CHUANGSUWANICH, MD, Prof. Scientific (Plastic Surgery)

Charan MAHATUMARAT, MD, Prof. Scientific (Plastic Surgery)Kamol WATTANAKRAI, MD Scientific (Plastic Surgery)Rataporn UNGPAKORN, MD FacilitiesSomsak TANRATANAKORN, MD RegistrationSuwirakorn OPHASWONGSE, MD, Assist. Prof. Public RelationsVesarat WESSAGOWIT, MD, PhD PublicationKobkul AUNHACHOKE, MD, Assoc. Prof. Treasurer

Pravit ASAWANONDA, MD ThailandRataporn UNGPAKORN, MD ThailandChariya PETCHNGAOVILAI, MD ThailandJinda ROJANAMATIN, MD ThailandWoraphong MANUSKIATTI, MD ThailandSiriwat PATRAKARN, MD ThailandRungsima WANITPHAKDEEDECHA, MD ThailandRattapon THUANGTHONG, MD ThailandChanitwan TREEWITTAYAPOOM, MD ThailandMarisa PONGPRUTTHIPAN, MD, ThailandPinyapat KANECHORN, MD ThailandPakpilai THAVISIN, MD Thailand

Apirag CHUANGSUWANICH, MD, Prof. ThailandCharan MAHATUMARAT, MD, Prof. ThailandKamol WATTANAKRAI, MD Thailand

Pierre ANDRÉ, MD FranceClaude DALLE, MD FranceKoenraad DE BOULLE, MD BelgiumDavid LAI, MD Hong Kong/ChinaJamuna PAI, MD IndiaHervé RASPALDO, MD FranceInès VERNER, MD IsraelYoshikazu YONEI, Prof. JapanSabine ZENKER, MD Germany

WELCOME MESSAGE FROM THE SCIENTIFIC COMMITTEE

DERMATOLOGICAL SOCIETy OF THAILANDScientific and Organization Committee

THAI SCIENTIFIC COMMITTEE

Aesthetic Dermatology Plastic Surgery

International Scientific Committee

Venues

Supported by

Scientific OrganizationDermatological Society of Thailand

Royal Jubilee Building9th floor, number 2 Soi Sonvijai

New Petchburi, HuayKwangBangkapi, Bangkok 10320 - THAILAND

Tel. +66 (0)2 716 6857 - Fax. +66 (0)2 616 6255www.dst.or.th

Technical OrganizationEuroMediCom

2, rue de Lisbonne75008 Paris - France

Tel. +33 (0)156 837 800 - Fax. +33 (0)156 837 [email protected]

www.euromedicom.com

Main Congress: Friday 25 & Saturday 26 January 2013Bangkok Convention Centre at CentralWorld

999/99 Rama 1 Road, PathumwanBangkok 10330 - THAILAND

Tel +66 (0) 2100 1234 - Fax +66 (0) 2100 1235

www.centarahotelsresorts.com/cgcw

Pre-Congress courses: Thursday 24 January 2013King Chulalongkorn Memorial Hospital

(Faculty of Medicine - Chulalongkorn Univ.)1873 Rama IV road

Pathumwan, Bangkok 10330

Organization©

Bebo

y -

Fot

olia

.com

Page 3: PRELIMINARY PROGRAMcongresos-medicos.com/docs/15267/icad2013_preprog.pdf · HaiR TRanSPlanT •Causes of premature Hair loss in men, women and adolescent •Medical treatments to

PRE-CONGRESS COURSES - 1 dayKing Chulalongkorn Memorial Hospital (Faculty of Medicine - Chulalongkorn University)

TH

UR

SD

AY J

AN

UA

RY

24th

7:30 Registrations and BadgingROOM Room 1 Room 2 Room 3

Schedule A - courses 1-3-5

8:30 10:00

Course 1 - Part 1BOTUlinUM TOxin

Updated techniques for beginners and intermediate

Course 3 - Part 1FillERS

How to deal with difficult demands

Course 5 - Part 1 laSER anD liGHTS

Coffee break

10:30 12:30

Course 1 - Part 2BOTUlinUM TOxin

Updated techniques for beginners and intermediateLive Demonstrations

Course 3 - Part 2FillERS

How to deal with difficult demandsLive Demonstrations

Course 5 - Part 2laSER anD liGHTSLive Demonstrations

Lunch offered on siteSchedule B - courses 2-4-6

14:00 15:30

Course 2 - Part 1FillERS

Updated techniques for beginners and intermediate

Course 4 - Part 1BOTUlinUM TOxin

How to deal with difficult demands

Course 6 - Part 1HaiR TRanSPlanT

Coffee break

16:0018:00

Course 2 - Part 2FillERS

Updated techniques for beginners and intermediateLive Demonstrations

Course 4 - Part 2BOTUlinUM TOxin

How to deal with difficult demandsLive Demonstrations

Course 6 - Part 2 HaiR TRanSPlanTLive Demonstrations

mAiN CONGRESS - 2 days

fRiD

AY J

AN

UA

RY

25th

7:30 Registrations and BadgingROOM Bangkok Convention Centre (BCC) A1 Lotus Suite 5-6 Lotus Suite 7

8:30 10:00

FaCE TO FaCEFaCial COnTOURinG: MiniMally invaSivE TREaTMEnT

Facial anatomy, Male vs female face –What’s important in the right and less invasive restoration, Threading, Threading - Korean perspectives, Eye reshaping, Nose contouring

COMPany’S SyMPOSiUM

COMPany’S SyMPOSiUM

Coffee break

10:30 12:00

BEaUTy anD THE BREaST(BODy COnTOUR/CEllUliTE)

Breast Surgery, Breast augmentation and reduction, Moving the Breasts north and south, Cellulite, Etc…

COMPany’S SyMPOSiUM

COMPany’S SyMPOSiUM

Lunch offered on site

14:0015:30

TERMinaTOR: THE aBS, DiETS, ExERCiSEPhysiology of the Fat, Hormonal changes after liposuction, 360-degree working injectables for lipolysis, Lipolysis, Lipoplasty/Liposculpting, Bariatric Surgery, Pills and Drinks (L-carnitine etc.)

COnTRiBUTinG lECTURES 1

COMPany’S SyMPOSiUM

Coffee break

16:0018:00

STEM CEllS/ CliniCal & BaSiC SCiEnCEAdipocyte Stem cells, Hair stem cells, Autologous stem cells, Asian perspectives, Thai

perspectives

COnTRiBUTinG lECTURES 2

COMPany’S SyMPOSiUM

SA

TU

RD

AY J

AN

UA

RY

26th

7:30 Registrations and Badging

8:30 10:00

THE TRanSFORMERSBEST OF BOTUlinUM TOxinS / DERMal FillERS

Lateral cheekbones, lips and nose profile - necessary basic details for an effective correction, Novel fillers, Future trends, Downsides, Beyond hyperhidrosis

COMPany’S SyMPOSiUM

COMPany’S SyMPOSiUM

Coffee break

10:30 12:00

HaiRy POTTERWhat’s New in Alopecias, Hair transplantation, Growing Hair with Light, Saw palmetto and other

botanical extracts, Mesotherapy and Alopecias, Laser hair removal

COnTRiBUTinG lECTURES 3

COMPany’S SyMPOSiUM

Lunch offered on site

14:0015:30

aCnE anD SCaR WaRS Chemical peels, Fractional Lasers for Acne Scars, Diet, Roles of Diet

and Hormone, …

COMPany’S SyMPOSiUM

COMPany’S SyMPOSiUM

Coffee break

16:0018:00

ManaGEMEnT OF THE lOWER FaCE(ManDiBUlaR linE anD liP EnHanCEMEnT)

Anatomical structures that determine the mandibular area, Mandibular contouring - don’t forget the chin!, Surgery of the aging lips: Risks and benefits, The quest for natural appearing lips : Everyone does not want Hollywood Lips, Needle vs Cannula injections for the lip: Pros & Cons, Combined

treatment for perioral area

COMPany’S SyMPOSiUM

COMPany’S SyMPOSiUM

SC

HE

DU

LE A

T-A

-GLA

NC

E -

iCA

D 2

013

Pre-Congress courses will be conducted at the King Chulalongkorn Memorial Hospital (Faculty of Medicine - Chulalongkorn Univ.), Thursday 24 Jan. 2013. The Main Congress will be held at Bangkok Convention Centre at CentralWorld, Friday 25 & Saturday 26 January 2013.

© be

rduc

hwal

- F

lickr

.com

(CC)

Page 4: PRELIMINARY PROGRAMcongresos-medicos.com/docs/15267/icad2013_preprog.pdf · HaiR TRanSPlanT •Causes of premature Hair loss in men, women and adolescent •Medical treatments to

THURSDAY JANUARY 24 - PRE-COURSES7:30 Registrations and Badging

roomKing Chulalongkorn Memorial Hospital (Faculty of Medicine - Chulalongkorn University)

ROOM 1 ROOM 2 ROOM 3Schedule A - courses 1-3-5

8:30 10:00

Course 1 - Part 1BOTUlinUM TOxinUpdated techniques

for beginners and intermediate

• Introduction• Facial muscles and functional anatomy• Pharmacology of the different BoTN/

A-formulations, their preparation, dilution and conversion

• Patient assessment and management• BoNT/A for the upper face• BoNT/A for hyperhidrosis

Course 3 - Part 1FillERS

How to deal with difficult demands

• Philosophy of non-surgical augmentation (theory on the facial structure and marking points)

• Volumization of the face with fillers for a youthful look (various areas to be treated, mid face & temporals)

• Rejuvenation of the periorbital area

Live Demo:• Mid face volumization with fillers• Rejuvenation of the periorbital area

Course 5 - Part 1laSER anD liGHTS

• Brief Review of the basic physics and clinical applications of a wide variety of laser modalities

• Use of lasers for vascular lesions, pigment problems, hair removal and epidermal and dermal entities

• Advanced Laser Dermatology and Innovation in Laser technology

Coffee break

10:30 12:30

Course 1 - Part 2BOTUlinUM TOxinUpdated techniques

for beginners and intermediate

Live Demo:• BoNT/A for the upper face

- glabella- crow`s feet- forehead

• BoNT/A for axillaris hyperhidrosis

Course 3 - Part 2FillERS

How to deal with difficult demands

• Lip augmentation• Jaw contouring (with fillers and in

combination with Botulinum toxin)• Possible complications with Fillers• Resorbable threads vs. fillers?

Live Demo: • Lip Augmentation and Jaw Contouring• Upper face volumisation / temporal

areas / brow area

Course 5 - Part 2laSER anD liGHTS

• Live demonstration of the latest laser technologies

Lunch offered on siteSchedule B - courses 2-4-6

14:00 15:30

Course 2 - Part 1FillERS

Updated techniques for beginners and intermediate

• Insights on Beauty and Aging• Facial Anatomy and Evaluation• When, Where and How to Use Fillers• Fillers: Concepts and Methods

Course 4 - Part 1BOTUlinUM TOxin

How to deal with difficult demands

• Introduction• BoNT/A for advanced indications

(lower face, platysma bands, masseter, decolleté lines etc.)

• Prevention and management of complications

• Different injection techniques for BoNT/A• Combining BoNT/A and dermal filler

for a 3-dimensional facial approach

Course 6- Part 1HaiR TRanSPlanT

• Causes of premature Hair loss in men, women and adolescent

• Medical treatments to stop Hair Loss• Hair transplant basics• Patient evaluation and selection• Ground breaking development and

FUE trends

Coffee break

16:0018:00

Course 2 - Part 2FillERS

Updated techniques for beginners and intermediate

Live Demo:Demonstrations of different injection techniques:

- Basic injection techniques- Nasolabial fold- Marionette lines- Cheecks & Cheeckbones- Jawline- Lips

Course 4 - Part 2BOTUlinUM TOxin

How to deal with difficult demands

Live Demo:• BoNT/A for advanced indications• Combination BoNT/A and dermal filler

Course 6 - Part 2HaiR TRanSPlanT

• Live Hair Transplantation Surgery Demonstration: Step-by-step

official Language

Page 5: PRELIMINARY PROGRAMcongresos-medicos.com/docs/15267/icad2013_preprog.pdf · HaiR TRanSPlanT •Causes of premature Hair loss in men, women and adolescent •Medical treatments to

fRiDAY JANUARY 25 - mAiN CONGRESS7:30 Registrations and Badging

room

Bangkok Convention Centre at CentralWorldBANGKOK CONvENtION CENtRE

(BCC) A1 LOtUS SUItE 5-6 LOtUS SUItE 7

8:30 10:00

FaCE TO FaCEFaCial COnTOURinG:

MiniMally invaSivE TREaTMEnT

• Facial anatomy• Male vs female face –What’s important in

the right and less invasive restoration• Threading• Threading - Korean perspectives• Eye reshaping• Nose contouring

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Coffee break

10:30 12:00

BEaUTy anD THE BREaST(BODy COnTOUR/CEllUliTE)

• Breast Surgery• Breast augmentation and reduction• Moving the Breasts north and south• Cellulite• Etc…

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Lunch break

14:00 15:30

TERMinaTOR: THE aBS, DiETS, ExERCiSE

• Physiology of the Fat• Hormonal changes after liposuction• 360-degree working injectables for

lipolysis• Lipolysis• Lipoplasty/Liposculpting• Bariatric Surgery• Pills and Drinks (L-carnitine etc.)

COnTRiBUTinG lECTURES 1Company’s symposium

Sponsored Workshop and/or Live demonstration on the

company’s latest technologies

Coffee break

16:3018:30

STEM CEllS/ CliniCal & BaSiC SCiEnCE

• Adipocyte Stem cells• Hair stem cells• Autologous stem cells• Asian perspectives• Thai perspectives

COnTRiBUTinG lECTURES 2Company’s symposium

Sponsored Workshop and/or Live demonstration on the

company’s latest technologies

official Language

Page 6: PRELIMINARY PROGRAMcongresos-medicos.com/docs/15267/icad2013_preprog.pdf · HaiR TRanSPlanT •Causes of premature Hair loss in men, women and adolescent •Medical treatments to

SATURDAY JANUARY 26 - mAiN CONGRESS7:30 Registrations and Badging

roomBangkok Convention Centre at CentralWorld

BANGKOK CONvENtION CENtRE (BCC) A1 LOtUS SUItE 5-6 LOtUS SUItE 7

8:30 10:00

THE TRanSFORMERSBEST OF BOTUlinUM TOxinS /

DERMal FillERS

• Lateral cheekbones, lips and nose profile - necessary basic details for an effective correction

• Novel fillers• Future trends• Downsides• Beyond hyperhidrosis

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Coffee break

10:30 12:00

HaiRy POTTER

• What’s New in Alopecias• Hair transplantation• Growing Hair with Light• Saw palmetto and other botanical

extracts• Mesotherapy and Alopecias• Laser hair removal

COnTRiBUTinG lECTURES 3

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Lunch offered on site

14:00 15:30

aCnE anD SCaR WaRS

• Chemical peels• Fractional Lasers for Acne ScarsDiet• Roles of Diet and Hormone• Acne Scars

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Coffee break

16:3018:30

ManaGEMEnT OF THE lOWER FaCE(ManDiBUlaR linE anD liP

EnHanCEMEnT)

• Anatomical structures that determine the mandibular area

• Mandibular contouring - don’t forget the chin!

• Mesohydratation: A new approach to wrinkle treatment for lower face and neck

• Surgery of the aging lips: Risks and benefits

• The quest for natural appearing lips : Everyone does not want Hollywood Lips

• Needle vs Cannula injections for the lip: Pros & Cons

• Combined treatment for perioral area

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

Company’s symposiumSponsored Workshop and/or Live demonstration on the

company’s latest technologies

official Language

Page 7: PRELIMINARY PROGRAMcongresos-medicos.com/docs/15267/icad2013_preprog.pdf · HaiR TRanSPlanT •Causes of premature Hair loss in men, women and adolescent •Medical treatments to

VENUES

Main Congress (Friday 25 & Saturday 26 January 2013)

Bangkok Convention Centre at CentralWorld999/99 Rama 1 Road, PathumwanBangkok 10330 - THAILANDTel +66 (0) 2100 1234 - Fax +66 (0) 2100 1235www.centarahotelsresorts.com/cgcw

Finally, a fully integrated world class convention venue, hotel, retail and leisure complex in the heart of Bangkok. Centara Grand & Bangkok Convention Centre at CentralWorld is located within the central business district.Location: • 30 minutes from Suvarnabhumi International Airport • BTS sky-train stations: “Chidlom” and “Siam” are linked via sky-walk

Pre-Congress courses (Thursday 24 January 2013)

Chulalongkorn Hospital (Faculty of medicine - Chulalongkorn University)King Chulalongkorn Memorial Hospital1873 Rama IV roadPathumwan, Bangkok 10330Location: • BTS sky-train station: “Sala Daeng”

• MRT underground station: “Sala Daeng”

ACCOMMODATIONS

The international first class hotels, recommended to the ICAD 2013 participants as listed on the registration form, are situated within the closest distance to CentralWorld with an exception of Centara Grand which is at CentralWorld. All of these hotels are located in the heart of the city’s Business, Shopping, Commercial, Financial and Entertainment districts and just 30 minutes from Bangkok International Suvarnabhumi Airport by the expressway. The near-by BTS Sky Train and MRT underground Stations will facilitate the travelling during your stay at the hotels. Please find more information of these hotels on their respective websites. To benefit from the special rates proposed by these hotels, please use the hotel reservation form to book your room before January 11, 2013.

AIR TRANSPORTATION

The airlines of SKYTEAM, Official Alliance Network for our event, offer attractive airfares for participants.SKYTEAM comprises 9 leading international airlines: Aeroflot, Aeromexico, Air France, Alitalia, China

Southern Airlines, CSA Czech Airlines, Delta, KLM, Korean Air, serving 856 destinations in 169 countries with 13,133 flights daily.To benefit from these special offers, link up with www.skyteam.com/GlobalMeetings and quote the Identifier Code.Through this site you can also access the schedules of all SkyTeam partners to plan your flights on the airline of your choice.

INDENTIFIER CODE: 17347AFValid date range for discount: from January 19-31, 2013

LANGUAGES

Official language: English

VISA

Please note that for most countries no specific Visa is required to visit Thailand. If you require a visa invitation letter for inclusion with your entry VISA application, please DOWNLOAD it from our site www.euromedicom.com or contact us at [email protected].

CME CREDITS

INTErNATIoNAL ACCrEDITATIoN: Accreditation has been applied for from the UEMS-EACCME

REGISTRATION

To register to the ICAD 2013, complete the enclosed registration form and return it with the payment to Euromedicom.On line registration, with secured payment by credit card is available at: www.euromedicom.comOn site registration will be available each day of the congress.The delegate registration fee includes:- A badge, a congress bag, a conference book, all the congress documents and a diploma as a certificate of attendance to the scientific program.- Admission to the exhibition area and the conference rooms depending on your choice of registration (2-day pass or VIP full pass)- Coffee breaks and lunches offered on siteCancellation policy: • +30 days before: Total refund -50 euros • Between 30 and 15 days: Refund -30 % • -15 days before: No refund. Cancellation will be processed following to the written request and at one month after the congress

Thailand Convention & Exhibition Bureau (TCEB) provides supports to the ICAD 2013. All international delegates will be granted with 3-day pre-paid BTS cards facilitating their travelling during the congress period. Upon the arrival to the Suvarnabhumi International airport, an immigration clearance process can be facilitated. Any delegate wishing to have this service shall provide us with their passport number, flight number and arrival times in advance of 15 days minimum before their arrival at the airport.

GENERAL iNfORmATiONofficial Language

© su

rang

aw, F

otol

ia.c

om -

© z

oona

bar,

Flic

kr.c

om (C

C)

Page 8: PRELIMINARY PROGRAMcongresos-medicos.com/docs/15267/icad2013_preprog.pdf · HaiR TRanSPlanT •Causes of premature Hair loss in men, women and adolescent •Medical treatments to

ICAD 2013, RegIstRAtIon foRmInternational Congress in Aesthetic Dermatology

24-25-26 January 2013Bangkok Convention Centre at Central World

Once your credit card debited we will destroy your payment details - Please do not send your scanned registration by email but only by fax. ON-LINE REGISTRATION (Secured Payment) / inscription en ligne (Paiement sécurisé) : WWW.EUROMEDICOM.COM

Please fill one form per registrant and send it (or copy) to:EuroMediCom - 2, rue de Lisbonne - 75008 Paris - France - Tel: + 33 (0)1 56 83 78 00 - Fax: +33 (0)1 56 837 805 - E-mail: [email protected]

On line registration with secured credit card payment at www.euromedicom.com

Family Name First Name

Medical Specialty (obligatory field)

Address

Zip code City Country

Phone Fax

please, Use Capital letters

E-mail:

RegIstRAtIon fees:

PAYment

n VIP FULL Pass: access to 2-day Congress (25-26 Jan.) + aLL Pre-congress courses (24 Jan.) Delegate 650 € 650 € Member of Co-sponsor society (DsT, Wosiam) *Certification required 560 € 560 €Please, specify your 2 preferred courses below (1 in schedule A + 1 in schedule B) n 2-DaY CONGREss ONLY (Pre-courses NOt included) – JaNUaRY 25-26, 2013 Delegate 420 € 510 € Member of Co-sponsor society (DsT, Wosiam) *Certification required 340 € 420 € In-training (Resident/student/Diploma) *Certification required 260 € 340 €

n PRE-COURsE (MUsT register 2-day Congress) - JaNUaRY 24, 2013** Please choose ONLY ONE of the courses FOR EACH allocated schedule:Schedule A (8:30 - 12:30) Course 1: Botulinum toxin (Updated techniques for beginner & intermediate) 130 € 170 € Course 3: Fillers (How to deal with difficult demands) 170 € 210 € Course 5: Laser and Lights 85 € 130 €Schedule B (14:00 - 18:00) Course 2: Fillers (Updated techniques for beginner & intermediate) 130 € 170 € Course 4: Botulinum toxin (How to deal with difficult demands) 170 € 210 € Course 6: Hair Transplant 85 € 130 €

n Pass VIsITOR (Exhibition & Workshops ONLY) - JaNUaRY 25-26, 2013 Unique rate for all the participants (Delegate, Member, student, etc.) 150 € 200 €

Fees include your choice of registration, a certificate of attendance, a congress bag, the officiel congress book and access to coffee breaks and daily buffet lunches on site

Your confirmation & invoice will be sent by e-mail - Please write as CLEARLY as possible

Before After Dec. 15th Dec. 15h 2012 & Onsite

TOTAL: ...........................................€ Bank check in Euros enclosed, payable to Euromedicom (France only) Bank transfer in Euros to Euromedicom - ADD 15 euros for bank charges

VERY IMPORTANT: For administrative treatment purpose, BANK TRANSFER MUST BE MADE AT LEAST 10 DAYS PRIOR TO THE CONGRESS. Passed this date, the registrant may have to pay on site his registration and will be eventually refunded after the congress. The administrative process may take up to 30 days to identify the transfer before proceeding to the refund, after the event. MANDATORY: Do mention the REGISTRANT’S NAME + ICAD 2013 reference on all the bank documents.

Paying bank: CIC La GarenneAddress: 4 Rpt du Souvenir FrançaisF-92250 La Garenne-Colombes

Account holder: EuroMediCom SASBank code: 30066Branch code: 10301

Account Nber: 00010811901 Key digits: 04BIC - SWIFT : CMCIFRPPIBAN : FR76 3006 6103 0100 0108 1190 104

!!!

Cancellation policy: • +30 days before: Total refund -50 € • Between 30 and 15 days: Refund -30 % • -15 days before: No refund. Cancellation will be processed following to the written request and at one month after the congress

Credit Card : Visa Eurocard / Mastercard American Express Diners

Credit card number : _____________ _____________ _____________ _____________

Cardholder’s name : ___________________________________________________________________

Expiry date : ________ / ________ 3 digits code or 4 digits code (AMEX): _____________

Signature:

*Caution: Registrations at special rate MUST BE accompanied by the corresponding certification (member of scientific society, student, resident, nurse) - Send by e-mail to [email protected] - or by fax: +33 1 56 83 78 05** All Pre-Congress courses will take place at the King Chulalongkorn Memorial Hospital (Faculty of Medicine - Chulalongkorn University)