ISPRM – Endorsed events – Monitoring report

Please provide the below information in order for the ISPRM education Committee to monitor and evaluate the endorsed event.

Meeting title:*
Dates (start & end date)*
Location (city, country)*
Contact person name*
First Last
Contact person email*
Please provide the following information on the ISPRM endorsed event:
Actual schedule of activities & speakers*
Please indicate the topics and time per activity
Total number of participants*
Please provide the total number of participants
Distribution of participants*
Please provide the number of paticipants for the following categories: 1) Physicians; PRM specialists, 2) Nurses, 3) Therapists, 4) Physicians, non‐PRM specialists, 5) Students/Trainees, 6) Other allied rehabilitation professionals (e.g., prosthetists, rehabilitation engineers)
Meeting goals and objectives*
Were the goals and objectives of the meeting achieved? (please state each goal/objective)
DISCLOSURES*
- Was the meeting content organized independently and without input from commercial entities?
- Were the speakers and organizers required to declare any conflict of interest with commercial entities?
Supporting documents
Please provide the following supporting documents (if feasible): 1) Evaluation report with participant responses 2) Copy of certificates given 3) Others (pictures etc)
Drop files here or
Max. file size: 12 GB, Max. files: 10.
How is the ISPRM endorsement valuable for your event?*
Please describe to us what the value is of ISPRM endorsement of your event
Signed by Name*
(NAME Meeting/Conference Organizer/Director)
First Last

Please provide the following information on the ISPRM endorsed event: