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The EHS International
MENTAL HEALTH
CONFERENCE - 2023
Date: 17 & 18 February 2023
Location: Shangri-La Hotel Dubai
Registration Form
Name
*
Surname
*
Your business email address
*
(private email addresses shall not be included)
Mobile phone number
*
Select Title
Clinical Psychologist
Consultant Psychiatrist
Education Professional
Educational Psychologist
General Nurse
General Practitioner
Health Care Management
Medical Physician
Medical Student
Mental Health Nurse
Occupational Therapist
Primary Care Physician
Psychiatric Resident
Psychologist
Psychology Student
Psychotherapist
Social Worker
Specialist Nurse
Specialist Psychiatrist
Other, please specify
Your Title
*
Please specify other Title
Select Affiliation
American University of Sharjah
DHA
DoH
EHS
Higher Colleges of Technology
Maudsley Health
Sharjah Health Authority
UAEU
University of Sharjah
Other, please specify
Affiliation
*
Please specify other Affiliation
Place of residence
Abu Dhabi
Dubai
Sharjah
Ajman
Umm Al Quwain
Ras Al Khaimah
Fujairah
Place of residence
*
Your preferred mode of attendance
*
In person
Virtual
Days you will attend
Day One
Day Two
Both Days
Days you will attend
*
You confirm you will attend the conference per the above details
*
Yes
No
Submit
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