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SOE Application

Surgeon of Excellence

IFSO-endorsed SURGEON OF EXCELLENCE PROGRAM
in EUROPE, MIDDLE EAST and AFRICA

Welcome to the Registration Process for Provisional Status

A complete application must consist of at least 2 application portfolios:
Surgeon + Institution(s) (one or more institutions)


Applying Surgeons may operate at at least one Institution fulfilling IFSO requirements in order to be designated as Surgeon of Excellence (SOE).

As soon as the application reaches EAC-BS and fees have also been paid, access codes will be provided in order to begin entering your bariatric patients in the International Bariatric Registry (IBARTM).

You have to fill in all the mandatory fields, otherwise you will not be able to finish the registration process.
As an applicant to participate in the IFSO-EC Surgeon of Excellence Program to be evaluated by the European Accreditation Council for Bariatric Surgery (EAC-BS)

Please agree to proceed
Please agree to proceed
Please agree to proceed

I also agree to the following terms and conditions:

Please agree to proceed
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Surgeon
Please proceed by filling-out the surgeon(s)'details. All fields need to be filled-out.

Please fill in surgeon's family name
Please fill in surgeon's first name
Please fill in surgeon's title
Please fill in surgeon's identification card
Please fill in surgeon's e-mail address
Please fill in surgeon's postal address
Please fill in surgeon's postal code
Please fill in surgeon's sity
Please fill in surgeon's country
Please fill in surgeon's phone number
Please fill in surgeon's fax number
Please fill in surgeon's cell phone

I hereby certify that all the information contained in this application is, to the best of my knowledge, true and
Please agree to proceed
Please agree to proceed

Please complete the following checklist. Include only those that the applying Surgeon is fulfilling:

Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
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Note: Additional information may be required by the Council. In this case you will be contacted by the Program Co-ordinator.
Note: Filling-out next surgeon's details in order to register a new surgeon or else press "Next" to proceed to the rest of the registration process.

Institution 1
Fill out this form and click Next in order to move to the next steps. All fields need to be filled-out.

Please select type of your facility
Please fill in revenue details
Please fill in the name of institution
Please fill in postal address of institution
Please fill in institution postal code
Please fill in 'City' field
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Please fill in institution's email address
Please fill in institution's website url
Please fill in 'Contact person' field
Please fill in your institution's phone number
Please fill in your institution's fax number
Please fill in a valid cell phone number

I hereby certify that all the information contained in this application is, to the best of my knowledge, true and
Please agree to proceed

Please complete the following checklist. Include only those that the applying Institution is fulfilling:

Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
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Please agree to proceed
Invalid Input
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Billing Information
Description
Amount
Participation fee
1200 €
Institution 1:
Total: 1200 €



Thank you, for your registration.

Please note that we will contact you soon, in order to inform you about your payment settlement.

Finalize your registration by pressing the submit button below or press "Add Institution" button in order to register a new institution
Institution 2
Fill out this form and click Next in order to move to the next steps. All fields need to be filled-out.

Please select type of your facility
Please fill in revenue details
Please fill in the name of institution
Please fill in postal address of institution
Please fill in institution postal code
Please fill in 'City' field
Invalid Input
Please fill in institution's email address
Please fill in institution's website url
Please fill in 'Contact person' field
Please fill in your institution's phone number
Please fill in your institution's fax number
Please fill in a valid cell phone number

I hereby certify that all the information contained in this application is, to the best of my knowledge, true and
Please agree to proceed

Please complete the following checklist. Include only those that the applying Institution is fulfilling:

Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Invalid Input
Invalid Input
Invalid Input


Billing Information
Description
Amount
Participation fee
1200 €
Institution 1:
Institution 2:
Total: 1200 €



Thank you, for your registration.

Please note that we will contact you soon, in order to inform you about your payment settlement.

Finalize your registration by pressing the submit button below or press "Add Institution" button in order to register a new institution
Institution 3
Fill out this form and click Next in order to move to the next steps. All fields need to be filled-out.

Please select type of your facility
Please fill in revenue details
Please fill in the name of institution
Please fill in postal address of institution
Please fill in institution postal code
Please fill in 'City' field
Invalid Input
Please fill in institution's email address
Please fill in institution's website url
Please fill in 'Contact person' field
Please fill in your institution's phone number
Please fill in your institution's fax number
Please fill in a valid cell phone number

I hereby certify that all the information contained in this application is, to the best of my knowledge, true and
Please agree to proceed

Please complete the following checklist. Include only those that the applying Institution is fulfilling:

Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Please agree to proceed
Invalid Input
Invalid Input
Invalid Input


Billing Information
Description
Amount
Participation fee
1200 €
Institution 1:
Institution 2:
Institution 3:



Thank you, for your registration.

Please note that we will contact you soon, in order to inform you about your payment settlement.

Finalize your registration by pressing the submit button below.