Registration form

Create User Account

* Email:
* Create New Password:
Must be at least 8 characters, include one uppercase, one lowercase, one number, and one special character.
* Confirm Password:
* Consent for personal data processing
Please be aware that when registering for participation in EAHIL2025, your personal data is processed for the purpose of administering the event. See Medical University of Lodz, 90–419 Łódź, Al. Kościuszki 4 Privacy Policy for more information on how personal data is processed by UMED, and your rights. If you have queries regarding data processing, please e-mail us at iod@umed.lodz.pl.
Please note that by attending the conference you consent to be photographed throught the event

Personal details

*Title:
*Name:
*Surname:
*Affiliation:
*Country:
*First-time attendee?
Yes No

Correspondence Address

*Postal Code/Zip Code:
*City/Town:
*Street:
*Need an Invoice?
Yes No