REGISTRATION FORM
(Please print this out and fax it back to Dr. Azucena
Aldaz at 34-948-175-278)
I wish to register to attend the Workshop on
Principles of Pharmacokinetics - Parametric and Nonparametric
Population PK and PD Modeling: Applications to Therapeutic Drug
Monitoring and to Optimal individualization of Drug Therapy
Thursday - Saturday, January 24-26, 2002.
Location: University of Navarra, Pamplona, Spain.
Name of Registrant ____________________________________________
Institution ____________________________________________
Address ____________________________________________
City, State, Zip ____________________________________________
Country ____________________________________________
Phone (____)_____________ Fax (____)______________
Email address ___________________________________________
Please return this form directly to:
Azucena Aldaz, Pharm. D.
Servicio de Farmacia, Facultad de Medicina,
Clinica Universidad de Navarra
Avda Pio XII, n 36
31008 Pamplona, Spain
Phone: 34-948-296-692, x4113, 4119
Fax: 34-948-175-278
Email: aaldaz@unav.es
I would also like to receive information about the USC software.
Yes _____
No _____
I heard about this conference from:
mailing _____
word of mouth _____
electronic bulletin board _____
web _____
other (please specify) _____