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Name
*
First Name
Last Name
Date of Birth
*
Nationality
*
Current Country of Practice
*
Title of Clinical Cardiology Higher Certificate
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Year Higher Certificate was Obtained
*
Please note that the higher certificate in cardiology must be three years or older.
Mobile Number
*
Email
*
File
*
Max. file size: 10 MB.
Please attach a certificate from the local GCC cardiac society indicating that you are recognized in the country as a Cardiologist practicing independently at the level of consultant.
File
*
Max. file size: 10 MB.
Please provide a letter from the local GCC cardiac society indicating you have paid the dues of $50 or its equivalent.