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About
Former Presidents
Honorary Advisors of the Board
Faculty
Local faculty
Organising Committee
Regional and International Faculty
Abstract
Programme
Programme
Programme Booklet
Announcement
First Announcement
Final Announcement
Registration
Registration Fee
Online Registration
Sponsorship
Sponsorship Opportunities
Sponsors
Destination
Conference Venue
Weather
Accommodation
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10ASEANMISST Reg ID
Delegate Information
(Information will be used for Certificate and CPE attendance submission)
Title
(Required)
Prof
A/Prof
Dr
Mr
Mrs
Mdm
Ms
Name
(Required)
First/Given Name
Last/Surname
Profession
(Required)
Medical Student
Resident
Fellow
Doctor
Physician
Scientist
Surgeon
Nurses
Country
(Required)
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
MCR/SNB Reg No
(Required)
Institution / Clinic / Organisation
(Required)
Division/Department
Contact No.
Email
(Required)
Enter Email
Confirm Email
Registration fee:
(Required)
I would like to attend:
Cadaver Workshop (26-27 Feb) and Main Conference (28 Feb – 1 March): USD 1,800 (THB 60,000)
Pain Workshop – Day Pass and Main Conference (28 Feb – 1 March): USD 300 (THB 10,500)
Pain Workshop – both days and Main Conference (28 Feb – 1 March): USD 600 (THB 21,000)
Main Conference
Pain Workshop - 1 Procedure: USD 80 (THB2,800)
Pain Workshop - Observer: USD50 (THB 1,750)
Cadaver Workshop (26-27 Feb) and Main Conference (28 Feb – 1 March)
(Required)
USD 1,800 (THB 60,000)
The technique I would like to attend:
(Required)
UBE
Uniportal
Not specific
Pain Workshop – Day Pass and Main Conference (28 Feb – 1 March)
(Required)
USD 300 (THB 10,500)
Pain Workshop – both days and Main Conference (28 Feb – 1 March): USD 600 (THB 21,000)
(Required)
USD 600 (THB 21000)
Kindly choose the date you will attend Pain Workshop:
(Required)
26 February 2025
27 February 2025
Main Conference
(Required)
Medical Students/Residents/Fellows
Main Conference
(Required)
Medical Students/Residents/Fellows
Main Conference
(Required)
Medical Students/Residents/Fellows
Main Conference
(Required)
Nurses: Complementary
Main Conference
(Required)
Medical Students/Residents/Fellows
Main Conference
(Required)
Doctors/Physicians/Scientists/Surgeons: USD 200 (THB 7,000)
Main Conference
(Required)
Doctors/Physicians/Scientists/Surgeons: USD 200 (THB 7,000)
Main Conference
(Required)
Doctors/Physicians/Scientists/Surgeons: USD 200 (THB 7,000)
Main Conference
(Required)
Doctors/Physicians/Scientists/Surgeons: USD 200 (THB 7,000)
Pain Workshop - 1 Procedure
(Required)
USD 80 (THB2,800)
Kindly choose the date you will attend Pain Workshop:
(Required)
26 February 2025
27 February 2025
Kindly choose your preferred procedure
(Required)
C-ESI / C-MBB(flu) c RFA
C-SNRB / C -MBB (u/s)
L-MBB / SI joint injection / caudal ESI (u/s)
Caudal ESI / pulse RF RCE (flu)
Kindly choose your preferred procedure:
(Required)
Cooled RF SI joint (flu)
L-MBB (flu) c RFA/Cooled RF
Sacral lateral branch RFA (flu)
SCS implantation (flu)
Pain Workshop - Observer
(Required)
USD50 (THB 1,750)
Kindly choose the date you will attend Pain Workshop:
(Required)
26 February 2025
27 February 2025
Voucher Code:
Total Payment:
Dietary Selection
(Required)
Normal
Vegetarian
Will you attend Gala dinner on 28 Feb 2025 at Eastin Thana City Golf Resort Bangkok (complementary)
(Required)
Yes
No
Mode of Payment:
(Required)
Cheque / Bank Draft
Bank Transfer
Credit card
Cheque / Bank Draft
Cheque / Bank Draft, in Bath Thai, should be crossed and made payable to “มูลนิธิโรงพยาบาลสมเด็จพระยุพราช สาขาท่าบ่อ” or “10th ASEANMISST 2025 Conference”. Kindly write the delegate’s name on the reverse side of the Cheque / Bank Draft and mail it to our conference secretariat, together with registration acknowledgement email.
Bank Transfer
Bank details will be sent to your email for payment once registration form is submitted
Kindly write to our secretariat at
info@aseanmisst.org
for further assistance.
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