Answer the Questions bellow! :

Full Name :
NRA PERDAMI :
Email :
Year completed of Residency :
Number of patients in your clinic per month:
Number of cases of Cataract in your clinic per month:
Have you done ECCE Cataract Surgery ?
Yes No
If Yes, How many cases ?:
Have you ever Phaco Wetlab ?
Yes No
If Yes, When?:

Where?:

Upload your Wetlab Certificate?:
* = Only JPG, PNG, PDF, or DOC file allowed with max size 200kb
Have you done of Phacoemulsification Cataract Surgery :
Yes No
If Yes,
Number of Phaco surgery?:
Where of Phaco surgery?:
Number of PCR cases ? :
Number of VP cases ? :
Number of Nucleus Drop cases ? :
What is dificulty of Phacoemulsification Cataract Surgery ?
What is your target after join the INASCRS Phaco Training ?