Angels Initiative Enrolment Form

PLEASE COMPLETE THE FIELDS BELOW
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1

Email Confirmation

2

Country and Organization

3

Personal Information

Select your organization type from the drop-down list.

Add at least one language so we can help tailor content and communications to you.

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The topmost language will be considered your primary language.

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ORGANIZATION

Select your organization from the drop down list or start typing to find your organization. If your organization is not on the list you can add it by clicking Add New Organization and filling out all the required fields. Your submission will then be approved by your Country Manager.

Terms and Conditions

The Angels Initiative is intended for the support of healthcare and does not constitute an inducement to recommend, prescribe, purchase, supply, sell or administer specific medicinal products.

I understand that the costs of the Angels Consultants will be covered by Boehringer Ingelheim. I understand that Boehringer Ingelheim will report costs incurred for transparency under EFPIA regulations as amount per hospital/per country.

I understand that no action or omission by the Angels Consultants or any other third party used within the program will create any liability towards Boehringer Ingelheim. I understand that if my hospital desires to implement proposals detailed within the initiative or any other platform, it happens at the hospital’s own risk and without liability of Boehringer Ingelheim.

By registering on this website, I hereby confirm that I am a healthcare professional affiliated with the hospital which I have selected above.

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