Dear Clinician:

Quintiles Medical Education Inc., offers several continuing medical education (CME) grand rounds series. Please complete the form below and we will send more information about our available programs including instructions on how to schedule a meeting at your facility.


INFORMATION REQUEST FORM
Salutation*
  
First Name*
Last Name*
 
 
Degree(s)
Specialty
Organization*
Profession
 
 
Street Address
Suite
City
State/Province
ZIP
    
     
Day Phone*
Evening Phone
Fax
    
E-mail*
    
(Confirmation of registration will be sent to this e-mail address.)

Please check the therapeutic area(s) you are interested in.
Hematology/Oncology
Cardiology
Endocrinology
Infectious Diseases
Internal Medicine
Nephrology
Other:

      I prefer to receive my program information by (check one) Email | Fax
Yes, you have my permission to fax and/or e-mail information to me about future CME activities.

Quintiles Medical Education Inc., is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians.


 

 

If you have any questions regarding this program, please contact the Customer Support Center at 1-866-832-7178 or email us at cmegr@quintiles.com.