Application Form

Application details
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I am applying for
Criteria Confirmation
- I confirm I meet the criteria
National Association letter of support
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Accepted file types: dcox, pdf, Max. file size: 100 MB.
Please upload a letter of support from your national association. The letter should confirm your membership status (paid) and should acknowledge that you work in obesity management in your country

Additional Information
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I am certified physician or HCP*
- Yes
- No
Please provide details
I have undertaken training in a medical speciality relevant to obesity management (E.G. Diabetes; Dietetics; Endocrinology; Gastroenterology; Health/Clinical Psychology; Internal Medicine; Paediatrics; Physiotherapy; Primary Care; Surgery).*
- Yes
- No
Please provide details
Give details about your clinical experience in obesity management with particular reference to referral of patients who are difficult to treat (not less than 5 years for National Fellow and 10 years for European fellow)
I have a continuing interest and updating in obesity management as shown by participation in international scientific meetings (3 congress participations with accepted abstracts or invited presentations in the last 5 years, notably ECO). List recent conference participation and presentations.
Give details of at least 10 international, peer-reviewed publications on obesity or obesity-related diseases, preferably published over the last 5 years, or 20 publications with no time limit.
Publications
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Accepted file types: docx, pdf, doc, Max. file size: 100 MB.
Please upload a list of your top 10 publications

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