i3 Health - 213NSCLC: 213NSCLC - Leveraging the Growing Arsenal of Adjuvant Therapies for Early-Stage NSCLC

To request a meeting for your institution, complete the following Request a Meeting application. For questions, please contact Madelyne Fabrizio, Program Manager, at MFabrizio@i3Health.com or 973-928-8085 ext 216.

* = Required.

First Name:*

Please enter your first name.

Last Name*

Please enter your last name.

Email*

Please enter your email address.

Title*

Please enter your title (eg, Fellowship Director, CME Coordinator).

Phone*

Please enter your phone number.

Please rank the educational gap at your institution related to non-small cell lung cancer.

.

# of physicians expected to attend this activity?*

Please enter a response.

# of nurses expected to attend this activity?*

Please enter a response.

# of pharmacists expected to attend this activity?*

Invalid Input

# of other health care professionals expected to attend this activity?*

Invalid Input

Please let us know your preferred meeting dates and times by selecting a date within the range of 7/3/2023-5/15/2024 from the calendars below.

Date 1*

Please indicate a date and time.

Time of First Meeting Choice

Invalid Input

Date 2

Please indicate a date and time.

Time of Second Meeting Choice

Invalid Input

Date 3

Please indicate a date and time.

Time of Third Meeting Choice

Invalid Input

Please tell us about your meeting venue.

Meeting Location*

Please enter the name of the meeting site.

Meeting Phone*

Please enter the phone number for the meeting site.

Meeting Address 1*

Please enter the address of the meeting site.

Meeting Address 2

Please enter the address of the meeting site.

Meeting City*

Please enter the city of the meeting site.

Meeting State*

Please enter the state of the meeting site.

Meeting ZIP Code*

Please enter the ZIP Code of the meeting site.

AntiSpam*

Invalid Input