9446 ATTR-CM Grand Rounds Registration

Thank you for your interest in our education. Please provide us with the following information so we can schedule your grand rounds.

1. Which education are you interested in hosting?

ATTR-CM Case Challenges: Success Strategies for Genetic Testing

2. Name of your hospital or institution *This question is required.

3. City *This question is required.

4. State *This question is required.

5. Host Contact Name *This question is required.

6. Host Contact Email *This question is required. This question requires a valid email address.

7. Host Contact Phone Number *This question is required.

8. Audience (General cardiologists, heart failure nurses, heart failure specialists, echocardiographers, nuclear cardiologists, electrophysiologists), primary care clinicians (MDs/Dos, NPs, PAs), and other specialties who may encounter patients with potential or confirmed ATTR-CM) *This question is required.

9. Number of Expected Attendees *This question is required.

10. Potential Dates

11. Potential Time

12. Would you like The France Foundation to provide CME credit? *This question is required.

13. Virtual or in-person? *This question is required.

14. Would you like The France Foundation to host via Zoom? *This question is required.