Welcome to the Servier CFS Panel Discussion on Wednesday, November 12th at 5:45 PM - 7 PM at the New York Hilton Midtown, 1335 Avenue of the Americas, NYC. (Dinner buffet open at 5:45, program starts at 6)

Question Title

* 1. Name

Question Title

* 3. Affiliation/Organization

Question Title

* 4. NPI Number

Question Title

* 5. Street Address

Question Title

* 6. City

Question Title

* 7. State

Question Title

* 8. Zip Code

Question Title

* 9. Mobile Phone number

Question Title

* 10. Do you have dietary restrictions? (if yes, please specify)

Attendee and Reporting Policy

This non-CME accredited educational program is intended for US healthcare professionals who treat or are reasonably expected to treat patients within the FDA-approved patient population for the Company product and who have a bona fide educational need to receive the Speaker Program information.

Friends, significant others, family members, and other guests may not attend this program.

The Company will not pay for or provide alcohol at this program. The value of any meals or items provided to program participants may be reported in accordance with applicable federal and state laws.

Healthcare professionals from certain states or institutions that restrict healthcare professionals from accepting meals or other transfers of value from pharmaceutical companies must adhere to all restrictions and requirements imposed by the law or their institution.

T