new contact form – germany | New England School of Homeopathy

new contact form – germany


I am filling out this contact form in order to*:	Register for the NESH 2021 Conference in GermanyTo ask questions about the NESH 2021 Conference in Germany

First Name (Given Name)*:
Last Name (Family Name)*:
Degree (if any):
E-Mail* (please double check to confirm correct):
Street Address*:
City/Town*:
State*:
Zip/Post Code*:
Country*:
Phone Number*:
Location & year(s) I have studied with Dr. Herscu*:
How did you hear about this NESH 2021 Conference?*
Questions / Comments:
How do you plan to pay for this seminar? (see options above)*
Written Informed Consent: I have read and understood the conditions of participation and agree to these conditions (see below).
Registrant’s Signature (typing your full name here serves as your electronic signature)*:
Date*:

Conditions of Participation:
Registration for the respective seminar becomes valid through the confirmation of registration by the organizers. Complete cancellation is possible until 4 weeks before the seminar with 25€ / $30 handling charge. In cases of later cancellation, the full fee shall be retained. Visual recordings and audio recordings are prohibited. All information about patients is subject to strictest professional medical confidentiality. All violations will be prosecuted. NESH is not liable for material damage or personal injury. Audio-visual recordings are being made of the case-taking and treatment of patients and of the conducted seminar to be used for training and further education of homeopaths. NESH is entitled to store and use the recorded material in accordance with the provisions of the German Federal Data Protection Act. The recordings are being used by NESH or duly authorized companies to conduct video-seminars and to create and sell data media (for example DVDs or online with streaming-technology on a website through a protected, password-secured access). Only those homeopaths who have provided means of appropriate identification will receive a password. Data media can also only be acquired by homeopaths who have provided means of appropriate identification. Participants in live seminars will inevitably be recorded during the seminars as well. With your participation you agree to be visible on data media.