COSOSA Conference 26 – 27 May 2023 Expression of Interest Please complete the following fields so we may supply you with more information about the COSOSA Cardio-Oncology Conference, 26 – 27 May 2023 Please enable JavaScript in your browser to complete this form.TitleName *FirstLastEmail *Speciality *CardiologistCardiology Fellow (Year 1)Cardiology Fellow (Year 2)Cardiology Fellow (Year 3)HaematologistMedical OncologistMedical Oncology Fellow (Year 1)Medical Oncology Fellow (Year 2)Medical Oncology Fellow (Year 3)Radiation OncologistRadiation Oncology Fellow (Year 1)Radiation Oncology Fellow (Year 2)Radiation Oncology Fellow (Year 3)RadiologistSpecialist PhysicianSurgeon (General)Surgeon (Specialist)OtherSpeciality – Other *Only indicate if none of the above is applicable. Please type N/A if an option above was chosen.Consent *I understand the purpose for disclosing this personal information. Collection of this information complies with The Protection of Personal Information Act 4 of 2013 (POPI), South Africa. If you have any questions about the Privacy Policy contact info@cososa.org Submit