CX 2023 Grant Application Form

Important: Priority will be given to HCPs who are able and willing to attend the whole meeting from Tuesday 25th – Thursday 27th April 2023. We reserve the right to put successful applicants on a waiting list should they be unable to meet these requirements.

  • The grant covers the cost of Full registration for the hybrid 3-day meeting, travel to the symposium (economy flight/train), 3 nights’ hotel stay at the Hilton London Metropole (single occupancy, including breakfast)
  • We are also able to offer grants for Virtual attendance of the meeting. These grants will cover the costs for Virtual registration for the hybrid 3-day meeting
  • Requests will be reviewed by a Grants Review Panel and will be allocated on a first come first served basis
  • The meeting organisers (BIBA Medical) adhere to the rules of the MedTech Europe code
  • We request that successful applicants complete a short feedback questionnaire during or after the event in order to improve the process for future years

GDPR DISCLAIMER: In order to comply with the MedTech Europe Codes of Ethical Business Practice or locally applicable laws for the medical device industry, we are required to notify Healthcare Professionals (“HCP”) of the necessary transfer of data to MedTech. This will comprise of your full name, professional address including phone and email, unique ID number (i.e. your registration number as a physician) and agreement details including but not limited to fees, accommodation & travel expenses, meals, etc. (the Benefits). If so required, it may also contain the HCP’s personal address, date of birth and tax ID. In particular, such details will be requested post-event for Portugal, France, Italy and Netherlands.

Important information about cancellations and no-shows

  • Cancellation fees will be charged after 27th February
  • In the event of cancellation after this date we ask that you source a suitable replacement
  • We will be tracking attendance online and in the event of a no-show the deposit will not be returned

Completed forms should be submitted no later than 1200 GMT on 4th March 2023

If you have any queries please email [email protected]

    I confirm that I have read and understand the above information:

    I Confirm

    Application Form

    Title (required):

    First Name (required):

    Surname/Family Name (required):

    Institution (required):

    Job title (required):

    Job Speciality (required):

    Other speciality:

    How would you like to attend CX Symposium 2023? (required)

    Address details

    Address Line 1 (required)*:

    Address Line 2:

    City/Town (required)*:

    County:

    Country (required)*:

    PLEASE NOTE Only HCPs from the following countries are eligible:

    Austria, Denmark, France, Germany, Iceland, Ireland, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom

    As per French legislation only HCPs who have completed their full Cycle 3 - DES in their speciality are eligible for grant funding:

    I confirm that I have completed Cycle 3 - DES in my speciality

    Identification number (RPPS for physicians, Semester for medical students) (required):

    Please Note: If your application is successful, any financial support towards your participation will be subject to the approval of the Mdeon Visa; this is a legal requirement and you will therefore be expected to provide additional information upon request of BIBA Medical. Failure to submit the required information will result in your application being rejected. I agree

    Post code/Zip Code (required)*:

    Email address (required)*:

    Email address 2 (e.g. assistant / personal email address):

    Telephone number (required)*:

    Mobile/Cell number:

    Please let us know how you will benefit from attending CX:

    Please let us know your main area of interest at the event (please select from drop-down menu):

    Please let us know your secondary area of interest at the event (please select from drop-down menu):

    Please let us know your third area of interest at the event (please select from drop-down menu):

    By submitting this form, I certify that all information provided in my application is true and correct to the best of my knowledge: (please tick)

    I Confirm

    What We Do With Your Data

    We will use your email to share important announcements about the CX Symposium. This includes information about your pass, registration, and programme updates.

    We may make limited registration information available to our sponsors, limited to your name, email, speciality, institution and country. This is in our and our sponsors' legitimate business interests: it allows us to attract the most appropriate sponsors for the Symposium and to facilitate business-to-business communication between our sponsors and our registrants.

    We will never share your personal contact information such as your email address, phone number or postal address.

    I confirm that I am happy for limited information to be shared with sponsors of the CX Symposium for the legitimate reasons detailed above
    I do not want limited information to be shared with sponsors of the CX Symposium

    We would also like to share information about Vascular News, Venous News, iWound News and Interventional News.

    If you would like a complimentary issue of the following related publications, please tick below (note: this will update your existing subscriptions if you are already on our database):
    *Vascular NewsVenous NewsiWounds NewsInterventional News