Register – EUSTAR

Center Application Form

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Center Registration

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Center Registration

Affiliation to EUSTAR is open to all centers devoted to the care and study of systemic sclerosis (SSc). Requirement for center affiliation is the capacity to care for SSc patients according to the EUSTAR minimal clinical requirements.

Name(Required)

First Name Last Name

Email(Required)

Enter Email Confirm Email

Center Name(Required)

Country(Required)

Center Address(Required)

(street, postcode, city, country)

Center City(Required)

Principal Investigator(Required)

Prefix First Name Last Name

Principal Investigator’s email(Required)

Enter Email Confirm Email

Co-Worker(s)(Required)

First Name

Last Name

Click + to add Co-Worker

Co-worker(s) emails:(Required)

Click + to add Co-Worker emails

Upload a picture of the Principal Investigator

Max. file size: 20 MB.

Name

This field is for validation purposes and should be left unchanged.

Center Application Form​

Center Registration

Center Registration

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Center Application Form