CBHC EU conference - Expression of interest

Criteria for Participation for patient representatives

The criteria for participating are:

• Ability to work and communicate well in English (both written and verbally);
• Member of a representative membership-based patient organisation;
• Capacity to transfer learning and knowledge to peers within the organisation and their networks (ideally a board representative, director, policy or communication specialist within the organisation); • Familiarity with the cross-border healthcare legislation (e.g. through attending an EPF regional conference).

Participants must commit themselves to:
• Familiarising themselves with any pre-conference reading materials;
• Actively participating and engaging with representatives of NCPs;
• Disseminating the conference outcomes within their organisations and networks;
• Becoming a member of the informal network of patient leaders on cross-border healthcare and being willing to interact regularly with national contact points in future;
• Giving feedback on the impact of the directive over the next years.

2015 CBHC EU Conference - expression of interest PERSONAL DETAILS

Title (Mandatory)

Surname (Mandatory)

First Name(s) (Mandatory)

Role within the Patients' Organisation (Mandatory)

Name of the organisation (in English) (Mandatory)

Organisation level (Mandatory)

Organisation postal address (Mandatory)

Country (Mandatory)

Office phone number

Office fax number

Mobile phone number

E-mail (Mandatory)

I am interested to represent my CBHC country network at the CBHC EU conference organised in Brussels on 2 July (Mandatory) Yes

A thank you message should be seen following the submission of this form. If you don't see such a message this means that one of the mandatory field (marked with a *) is not filled. Please check. For any question don't hesitate to contact the event organisers at veronique.tarasovici@eu-patient.eu

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CBHC EU conference - Expression of interest

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