עמוד בית
Fri, 26.04.24

Physician Shared Contact Information Form

The IMA WF helps to facilitate networking, information exchange and collaboration opportunities for members abroad interested in developing social and/or professional ties with physicians in Israel.

Physicians who would like to share general information and contact details with colleagues in Israel and abroad may do so by completing the form below.

Please be aware that by completing this form you acknowledge that the details provided will be made available to other IMA WF members.

First Name:
Last name:
Desired username:
Choose a password:
Re-enter password:

Please be aware that by completing this form you acknowledge that the details provided will be made available to other IMA WF members.

Please enter your personal details below:

Full Name:
Nationality:
E-mail address:
Telephone No:
City/State:
Country:
Specialization(s) in (Field of Medicine):
University/Medicine School of Graduation:

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The IMA is not responsible for and expressly disclaims liability for damages of any kind arising from the use of or reliance on information contained within the site.

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