{"id":15026,"date":"2026-06-16T21:27:13","date_gmt":"2026-06-16T19:27:13","guid":{"rendered":"https:\/\/ssipm.ch\/ssipm-idsp-application\/"},"modified":"2026-08-27T10:15:19","modified_gmt":"2026-08-27T08:15:19","slug":"ssipm-idsp-application","status":"publish","type":"page","link":"https:\/\/ssipm.ch\/en\/for-physicians\/interdisciplinary-specialization-idsp\/ssipm-idsp-application\/","title":{"rendered":"SSIPM IDSP Application"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"15026\" class=\"elementor elementor-15026 elementor-2002\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-44607112 e-con e-atomic-element e-div-block-base e-44607112-da01db4 background-norm section-padding \" data-id=\"44607112\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"44607112\" data-e-type=\"e-div-block\" data-id=\"44607112\">\n    <div class=\"elementor-element elementor-element-5fb93bcc e-flex e-con-boxed e-con e-parent\" data-id=\"5fb93bcc\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-1d398607 e-con-full e-flex e-con e-child\" data-id=\"1d398607\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-24a565c0 elementor-widget elementor-widget-heading\" data-id=\"24a565c0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\">CERTIFICATION &amp; APPLICATION<\/span>\t\t\t\t<\/div>\n\t\t\t\t\t<h1 data-interaction-id=\"5f63d430\" class=\"heading-jakarta-60-700 e-5f63d430-3964445 margin-bottom-24 e-heading-base\" data-e-type=\"widget\" data-id=\"5f63d430\"><\/h1>\n\t\t\t\t\t<p class=\"paragraph-inter-18-400 e-3b4dc98a-d4bf0af e-paragraph-base\" data-interaction-id=\"3b4dc98a\" data-e-type=\"widget\" data-id=\"3b4dc98a\">Applications for the Interdisciplinary Focus SSIPM can only be submitted according to the 2023 training program as of January 2026. Please submit your application using the online form below. <\/p>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-18d39e73 e-con-full e-flex e-con e-child\" data-id=\"18d39e73\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5c5f71a8 elementor-widget elementor-widget-image\" data-id=\"5c5f71a8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/ssipm.ch\/wp-content\/uploads\/elementor\/thumbs\/ssipm_Idsp_antrag_zertifizierung-rsfv27ylhbdi0da26hnhgn72c1bahz74n1ysxf03wo.webp\" title=\"ssipm_idsp_application_certification\" alt=\"SSIPM IDSP Application for Certification\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-45a6a11 e-con e-atomic-element e-div-block-base background-norm section-padding \" data-id=\"45a6a11\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"45a6a11\" data-e-type=\"e-div-block\" data-id=\"45a6a11\">\n    <div class=\"elementor-element elementor-element-fa28133 e-con e-atomic-element e-div-block-base content-848 content-center padding-0 \" data-id=\"fa28133\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"fa28133\" data-e-type=\"e-div-block\" data-id=\"fa28133\">\n    \t\t\t<p class=\"margin-bottom-12 eyebrow-jakarta-12-600-uppercase e-fd9ddaf-d019edc e-paragraph-base\" data-interaction-id=\"fd9ddaf\" data-e-type=\"widget\" data-id=\"fd9ddaf\">Required Documents<\/p>\n\t\t\t\t\t<h2 data-interaction-id=\"4abb603\" class=\"heading-jakarta-36-700 margin-bottom-40 e-heading-base\" data-e-type=\"widget\" data-id=\"4abb603\">What to prepare for the application<\/h2>\n\t\t<div class=\"elementor-element elementor-element-b5c1754 e-con e-atomic-element e-div-block-base flex-column-12 padding-0 margin-bottom-24 \" data-id=\"b5c1754\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"b5c1754\" data-e-type=\"e-div-block\" data-id=\"b5c1754\">\n    <div class=\"elementor-element elementor-element-5a4dbbd e-con e-atomic-element e-div-block-base padding-0 flex-column-20 flex-row-20 flex-row-center-center \" data-id=\"5a4dbbd\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"5a4dbbd\" data-e-type=\"e-div-block\" data-id=\"5a4dbbd\">\n    \t\t\t<div class=\"e-3b376cf-eb70521 e-svg-base\" data-interaction-id=\"3b376cf\" data-e-type=\"widget\" data-id=\"3b376cf\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"36\" height=\"36\" viewBox=\"0 0 36 36\" fill=\"currentColor\"><rect width=\"36\" height=\"36\" rx=\"18\" fill=\"#122A49\"><\/rect><path d=\"M15.7462 15.006V12.78H19.6242V23H17.1322V15.006H15.7462Z\" fill=\"white\"><\/path><\/svg><\/div>\t\t<div class=\"elementor-element elementor-element-2952211 e-con e-atomic-element e-div-block-base padding-0 flex-row-4 e-2952211-2a0d423 \" data-id=\"2952211\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"2952211\" data-e-type=\"e-div-block\" data-id=\"2952211\">\n    \t\t\t<div class=\"icon-no-background icon-16 e-svg-base\" data-interaction-id=\"4c4c00b\" data-e-type=\"widget\" data-id=\"4c4c00b\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"currentColor\"><path d=\"M12.5 1.66675H5.00004C4.55801 1.66675 4.13409 1.84234 3.82153 2.1549C3.50897 2.46746 3.33337 2.89139 3.33337 3.33341V16.6667C3.33337 17.1088 3.50897 17.5327 3.82153 17.8453C4.13409 18.1578 4.55801 18.3334 5.00004 18.3334H15C15.4421 18.3334 15.866 18.1578 16.1786 17.8453C16.4911 17.5327 16.6667 17.1088 16.6667 16.6667V5.83341L12.5 1.66675Z\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M11.6666 1.66675V5.00008C11.6666 5.44211 11.8422 5.86603 12.1548 6.17859C12.4673 6.49115 12.8913 6.66675 13.3333 6.66675H16.6666\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M8.33329 7.5H6.66663\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M13.3333 10.8333H6.66663\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M13.3333 14.1667H6.66663\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\t\t\t\t\t<h2 data-interaction-id=\"552e471\" class=\"heading-jakarta-16-700 e-heading-base\" data-e-type=\"widget\" data-id=\"552e471\">Completed IDSP SSIPM application form<\/h2>\n\t\t\n<\/div>\n\n<\/div>\n\t\t\t<div class=\"elementor-element elementor-element-1tp1453 e-con e-atomic-element e-div-block-base padding-0 flex-column-20 flex-row-20 flex-row-center-center \" data-id=\"1tp1453\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"132a6c4\" data-e-type=\"e-div-block\" data-id=\"1tp1453\">\n    \t\t\t<div class=\"e-a40c0fa-9e4459c e-svg-base\" data-interaction-id=\"a40c0fa\" data-e-type=\"widget\" data-id=\"05k874p\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"36\" height=\"36\" viewBox=\"0 0 36 36\" fill=\"currentColor\"><rect width=\"36\" height=\"36\" rx=\"18\" fill=\"#122A49\"><\/rect><path d=\"M14.547 21.082C14.8643 20.83 15.009 20.7133 14.981 20.732C15.8956 19.976 16.6143 19.3553 17.137 18.87C17.669 18.3847 18.117 17.876 18.481 17.344C18.845 16.812 19.027 16.294 19.027 15.79C19.027 15.4073 18.9383 15.1087 18.761 14.894C18.5836 14.6793 18.3176 14.572 17.963 14.572C17.6083 14.572 17.3283 14.7073 17.123 14.978C16.927 15.2393 16.829 15.6127 16.829 16.098H14.519C14.5376 15.3047 14.7056 14.642 15.023 14.11C15.3496 13.578 15.7743 13.186 16.297 12.934C16.829 12.682 17.417 12.556 18.061 12.556C19.1716 12.556 20.007 12.8407 20.567 13.41C21.1363 13.9793 21.421 14.7213 21.421 15.636C21.421 16.6347 21.0803 17.5633 20.399 18.422C19.7176 19.2713 18.8496 20.102 17.795 20.914H21.575V22.86H14.547V21.082Z\" fill=\"white\"><\/path><\/svg><\/div>\t\t<div class=\"elementor-element elementor-element-1auzxl7 e-con e-atomic-element e-div-block-base padding-0 \" data-id=\"1auzxl7\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"53d5ea0\" data-e-type=\"e-div-block\" data-id=\"1auzxl7\">\n    \t\t\t<h2 data-interaction-id=\"19b12b4\" class=\"heading-jakarta-16-700 e-heading-base\" data-e-type=\"widget\" data-id=\"0fu2tfv\">Letter of sponsorship from the head of an SSIPM training center<\/h2>\n\t\t\n<\/div>\n\n<\/div>\n\n\t\t\t\t\t<div class=\"elementor-element elementor-element-0hko1lu e-con e-atomic-element e-div-block-base padding-0 flex-column-20 flex-row-20 flex-row-center-center \" data-id=\"0hko1lu\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"132a6c4\" data-e-type=\"e-div-block\" data-id=\"0hko1lu\">\n    \t\t\t<div class=\"e-a40c0fa-9e4459c e-svg-base\" data-interaction-id=\"a40c0fa\" data-e-type=\"widget\" data-id=\"023x30s\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"36\" height=\"36\" viewBox=\"0 0 36 36\" fill=\"currentColor\"><rect width=\"36\" height=\"36\" rx=\"18\" fill=\"#122A49\"><\/rect><path d=\"M14.4757 15.664C14.5131 14.6653 14.8397 13.8953 15.4557 13.354C16.0717 12.8127 16.9071 12.542 17.9617 12.542C18.6617 12.542 19.2591 12.6633 19.7537 12.906C20.2577 13.1487 20.6357 13.48 20.8877 13.9C21.1491 14.32 21.2797 14.7913 21.2797 15.314C21.2797 15.93 21.1257 16.434 20.8177 16.826C20.5097 17.2087 20.1504 17.47 19.7397 17.61V17.666C20.2717 17.8433 20.6917 18.1373 20.9997 18.548C21.3077 18.9587 21.4617 19.486 21.4617 20.13C21.4617 20.7087 21.3264 21.222 21.0557 21.67C20.7944 22.1087 20.4071 22.454 19.8937 22.706C19.3897 22.958 18.7877 23.084 18.0877 23.084C16.9677 23.084 16.0717 22.8087 15.3997 22.258C14.7371 21.7073 14.3871 20.8767 14.3497 19.766H16.6737C16.6831 20.1767 16.7997 20.5033 17.0237 20.746C17.2477 20.9793 17.5744 21.096 18.0037 21.096C18.3677 21.096 18.6477 20.9933 18.8437 20.788C19.0491 20.5733 19.1517 20.2933 19.1517 19.948C19.1517 19.5 19.0071 19.178 18.7177 18.982C18.4377 18.7767 17.9851 18.674 17.3597 18.674H16.9117V16.728H17.3597C17.8357 16.728 18.2184 16.6487 18.5077 16.49C18.8064 16.322 18.9557 16.028 18.9557 15.608C18.9557 15.272 18.8624 15.0107 18.6757 14.824C18.4891 14.6373 18.2324 14.544 17.9057 14.544C17.5511 14.544 17.2851 14.6513 17.1077 14.866C16.9397 15.0807 16.8417 15.3467 16.8137 15.664H14.4757Z\" fill=\"white\"><\/path><\/svg><\/div>\t\t<div class=\"elementor-element elementor-element-128j332 e-con e-atomic-element e-div-block-base padding-0 \" data-id=\"128j332\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"53d5ea0\" data-e-type=\"e-div-block\" data-id=\"128j332\">\n    \t\t\t<h2 data-interaction-id=\"19b12b4\" class=\"heading-jakarta-16-700 e-heading-base\" data-e-type=\"widget\" data-id=\"0j1059a\">Proof of competencies (see application form)<\/h2>\n\t\t\n<\/div>\n\n<\/div>\n\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-83cfc01 e-con e-atomic-element e-div-block-base padding-0 margin-bottom-24 flex-row-20 \" data-id=\"83cfc01\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"83cfc01\" data-e-type=\"e-div-block\" data-id=\"83cfc01\">\n    \t\t\t<div class=\"e-19e9c84-0708196 e-svg-base\" data-interaction-id=\"19e9c84\" data-e-type=\"widget\" data-id=\"19e9c84\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"36\" height=\"36\" viewBox=\"0 0 36 36\" fill=\"currentColor\"><rect width=\"36\" height=\"36\" rx=\"18\" fill=\"#122A49\"><\/rect><path d=\"M13.9487 21.18V19.248L18.3727 12.92H21.0467V19.108H22.1947V21.18H21.0467V23H18.6527V21.18H13.9487ZM18.8207 15.552L16.4687 19.108H18.8207V15.552Z\" fill=\"white\"><\/path><\/svg><\/div>\t\t<div class=\"elementor-element elementor-element-fee9e20 e-con e-atomic-element e-div-block-base padding-0 \" data-id=\"fee9e20\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"fee9e20\" data-e-type=\"e-div-block\" data-id=\"fee9e20\">\n    \t\t\t<h2 data-interaction-id=\"0910189\" class=\"heading-jakarta-16-700 padding-0 margin-bottom-8 e-heading-base\" data-e-type=\"widget\" data-id=\"0910189\">Logbook of interventions<\/h2>\n\t\t<div class=\"elementor-element elementor-element-061d863 e-con e-atomic-element e-div-block-base padding-0 flex-column-8 \" data-id=\"061d863\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"061d863\" data-e-type=\"e-div-block\" data-id=\"061d863\">\n    \t\t\t<div class=\"elementor-element elementor-element-10mqde5 e-con e-atomic-element e-div-block-base content-848 padding-0 e-9a59bf6-39d1789 flex-row-center \" data-id=\"10mqde5\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"9a59bf6\" data-e-type=\"e-div-block\" data-id=\"10mqde5\">\n    \t\t\t<div class=\"icon-no-background e-da5b203-5312858 icon-20 e-svg-base\" data-interaction-id=\"da5b203\" data-e-type=\"widget\" data-id=\"0vntl2p\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"currentColor\"><path d=\"M18.1675 8.33332C18.5481 10.2011 18.2769 12.1428 17.3991 13.8348C16.5213 15.5268 15.0899 16.8667 13.3438 17.6311C11.5976 18.3955 9.64221 18.5381 7.8036 18.0353C5.965 17.5325 4.35435 16.4145 3.24025 14.8678C2.12616 13.3212 1.57596 11.4394 1.68141 9.53615C1.78686 7.63294 2.54159 5.8234 3.81973 4.4093C5.09787 2.9952 6.82217 2.06202 8.70508 1.76537C10.588 1.46872 12.5157 1.82654 14.1667 2.77916\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M7.5 9.16659L10 11.6666L18.3333 3.33325\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\t\t\t\t\t<p class=\"paragraph-jakarta-16-400 e-bf2c76d-9fcffd5 e-paragraph-base\" data-interaction-id=\"bf2c76d\" data-e-type=\"widget\" data-id=\"07hoxnm\">If the training was completed at multiple training centers, please attach one form per<br\/>training center.<\/p>\n\t\t\n<\/div>\n\n\t\t\t\t\t<div class=\"elementor-element elementor-element-1qxd8bk e-con e-atomic-element e-div-block-base content-848 padding-0 e-9a59bf6-39d1789 flex-row-center \" data-id=\"1qxd8bk\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"9a59bf6\" data-e-type=\"e-div-block\" data-id=\"1qxd8bk\">\n    \t\t\t<div class=\"icon-no-background e-da5b203-5312858 icon-20 e-svg-base\" data-interaction-id=\"da5b203\" data-e-type=\"widget\" data-id=\"09aizks\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"currentColor\"><path d=\"M18.1675 8.33332C18.5481 10.2011 18.2769 12.1428 17.3991 13.8348C16.5213 15.5268 15.0899 16.8667 13.3438 17.6311C11.5976 18.3955 9.64221 18.5381 7.8036 18.0353C5.965 17.5325 4.35435 16.4145 3.24025 14.8678C2.12616 13.3212 1.57596 11.4394 1.68141 9.53615C1.78686 7.63294 2.54159 5.8234 3.81973 4.4093C5.09787 2.9952 6.82217 2.06202 8.70508 1.76537C10.588 1.46872 12.5157 1.82654 14.1667 2.77916\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M7.5 9.16659L10 11.6666L18.3333 3.33325\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\t\t\t\t\t<p class=\"paragraph-jakarta-16-400 e-bf2c76d-9fcffd5 e-paragraph-base\" data-interaction-id=\"bf2c76d\" data-e-type=\"widget\" data-id=\"14vt2hb\">At least 6 of the 18 listed interventions are required, with at least 5 performed independently<br\/>for each. In addition, 80 interventions must be documented. <\/p>\n\t\t\n<\/div>\n\n\t\t\n<\/div>\n\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-f629d84 e-con e-atomic-element e-div-block-base padding-0 flex-row-20 \" data-id=\"f629d84\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"f629d84\" data-e-type=\"e-div-block\" data-id=\"f629d84\">\n    \t\t\t<div class=\"e-ad513dd-5d314b2 e-svg-base\" data-interaction-id=\"ad513dd\" data-e-type=\"widget\" data-id=\"ad513dd\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"36\" height=\"36\" viewBox=\"0 0 36 36\" fill=\"currentColor\"><rect width=\"36\" height=\"36\" rx=\"18\" fill=\"#122A49\"><\/rect><path d=\"M21.2733 14.866H16.9053V16.798C17.0919 16.5927 17.3533 16.4247 17.6893 16.294C18.0253 16.1633 18.3893 16.098 18.7813 16.098C19.4813 16.098 20.0599 16.2567 20.5173 16.574C20.9839 16.8913 21.3246 17.302 21.5393 17.806C21.7539 18.31 21.8613 18.856 21.8613 19.444C21.8613 20.536 21.5533 21.404 20.9373 22.048C20.3213 22.6827 19.4533 23 18.3333 23C17.5866 23 16.9379 22.874 16.3873 22.622C15.8366 22.3607 15.4119 22.0013 15.1133 21.544C14.8146 21.0867 14.6513 20.5593 14.6233 19.962H16.9613C17.0173 20.2513 17.1526 20.494 17.3673 20.69C17.5819 20.8767 17.8759 20.97 18.2493 20.97C18.6879 20.97 19.0146 20.83 19.2293 20.55C19.4439 20.27 19.5513 19.8967 19.5513 19.43C19.5513 18.9727 19.4393 18.6227 19.2153 18.38C18.9913 18.1373 18.6646 18.016 18.2353 18.016C17.9179 18.016 17.6566 18.0953 17.4513 18.254C17.2459 18.4033 17.1106 18.604 17.0453 18.856H14.7353V12.766H21.2733V14.866Z\" fill=\"white\"><\/path><\/svg><\/div>\t\t<div class=\"elementor-element elementor-element-278f5ad e-con e-atomic-element e-div-block-base padding-0 \" data-id=\"278f5ad\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"278f5ad\" data-e-type=\"e-div-block\" data-id=\"278f5ad\">\n    \t\t\t<h2 data-interaction-id=\"6f49584\" class=\"heading-jakarta-16-700 padding-0 margin-bottom-8 e-heading-base\" data-e-type=\"widget\" data-id=\"6f49584\">Certificates of attendance<\/h2>\n\t\t<div class=\"elementor-element elementor-element-b741885 e-con e-atomic-element e-div-block-base padding-0 flex-column-8 \" data-id=\"b741885\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"b741885\" data-e-type=\"e-div-block\" data-id=\"b741885\">\n    \t\t\t<div class=\"elementor-element elementor-element-0ffluai e-con e-atomic-element e-div-block-base content-848 padding-0 e-9a59bf6-39d1789 flex-row-center \" data-id=\"0ffluai\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"9a59bf6\" data-e-type=\"e-div-block\" data-id=\"0ffluai\">\n    \t\t\t<div class=\"icon-no-background e-da5b203-5312858 icon-20 e-svg-base\" data-interaction-id=\"da5b203\" data-e-type=\"widget\" data-id=\"03l66cm\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"currentColor\"><path d=\"M18.1675 8.33332C18.5481 10.2011 18.2769 12.1428 17.3991 13.8348C16.5213 15.5268 15.0899 16.8667 13.3438 17.6311C11.5976 18.3955 9.64221 18.5381 7.8036 18.0353C5.965 17.5325 4.35435 16.4145 3.24025 14.8678C2.12616 13.3212 1.57596 11.4394 1.68141 9.53615C1.78686 7.63294 2.54159 5.8234 3.81973 4.4093C5.09787 2.9952 6.82217 2.06202 8.70508 1.76537C10.588 1.46872 12.5157 1.82654 14.1667 2.77916\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M7.5 9.16659L10 11.6666L18.3333 3.33325\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\t\t\t\t\t<p class=\"paragraph-jakarta-16-400 e-bf2c76d-9fcffd5 e-paragraph-base\" data-interaction-id=\"bf2c76d\" data-e-type=\"widget\" data-id=\"0kfzp6d\">SSIPM Theoretical Foundations of Intervention (1 day)<\/p>\n\t\t\n<\/div>\n\n\t\t\t\t\t<div class=\"elementor-element elementor-element-0njquga e-con e-atomic-element e-div-block-base content-848 padding-0 e-9a59bf6-39d1789 flex-row-center \" data-id=\"0njquga\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"9a59bf6\" data-e-type=\"e-div-block\" data-id=\"0njquga\">\n    \t\t\t<div class=\"icon-no-background e-da5b203-5312858 icon-20 e-svg-base\" data-interaction-id=\"da5b203\" data-e-type=\"widget\" data-id=\"16cjefq\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"currentColor\"><path d=\"M18.1675 8.33332C18.5481 10.2011 18.2769 12.1428 17.3991 13.8348C16.5213 15.5268 15.0899 16.8667 13.3438 17.6311C11.5976 18.3955 9.64221 18.5381 7.8036 18.0353C5.965 17.5325 4.35435 16.4145 3.24025 14.8678C2.12616 13.3212 1.57596 11.4394 1.68141 9.53615C1.78686 7.63294 2.54159 5.8234 3.81973 4.4093C5.09787 2.9952 6.82217 2.06202 8.70508 1.76537C10.588 1.46872 12.5157 1.82654 14.1667 2.77916\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M7.5 9.16659L10 11.6666L18.3333 3.33325\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\t\t\t\t\t<p class=\"paragraph-jakarta-16-400 e-bf2c76d-9fcffd5 e-paragraph-base\" data-interaction-id=\"bf2c76d\" data-e-type=\"widget\" data-id=\"0ko2bd1\">SSIPM Practical Intervention Course (ultrasound or cadaver course) (1 day)<\/p>\n\t\t\n<\/div>\n\n\t\t\t\t\t<div class=\"elementor-element elementor-element-18uw1mg e-con e-atomic-element e-div-block-base content-848 padding-0 e-9a59bf6-39d1789 flex-row-center \" data-id=\"18uw1mg\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"9a59bf6\" data-e-type=\"e-div-block\" data-id=\"18uw1mg\">\n    \t\t\t<div class=\"icon-no-background e-da5b203-5312858 icon-20 e-svg-base\" data-interaction-id=\"da5b203\" data-e-type=\"widget\" data-id=\"0otdwas\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"currentColor\"><path d=\"M18.1675 8.33332C18.5481 10.2011 18.2769 12.1428 17.3991 13.8348C16.5213 15.5268 15.0899 16.8667 13.3438 17.6311C11.5976 18.3955 9.64221 18.5381 7.8036 18.0353C5.965 17.5325 4.35435 16.4145 3.24025 14.8678C2.12616 13.3212 1.57596 11.4394 1.68141 9.53615C1.78686 7.63294 2.54159 5.8234 3.81973 4.4093C5.09787 2.9952 6.82217 2.06202 8.70508 1.76537C10.588 1.46872 12.5157 1.82654 14.1667 2.77916\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M7.5 9.16659L10 11.6666L18.3333 3.33325\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\t\t\t\t\t<p class=\"paragraph-jakarta-16-400 e-bf2c76d-9fcffd5 e-paragraph-base\" data-interaction-id=\"bf2c76d\" data-e-type=\"widget\" data-id=\"08o6w0n\">Swiss Pain Congress<\/p>\n\t\t\n<\/div>\n\n\t\t\t\t\t<div class=\"elementor-element elementor-element-18d6yf9 e-con e-atomic-element e-div-block-base content-848 padding-0 e-9a59bf6-39d1789 flex-row-center \" data-id=\"18d6yf9\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"9a59bf6\" data-e-type=\"e-div-block\" data-id=\"18d6yf9\">\n    \t\t\t<div class=\"icon-no-background e-da5b203-5312858 icon-20 e-svg-base\" data-interaction-id=\"da5b203\" data-e-type=\"widget\" data-id=\"04zqem1\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width: 100%; height: 100%; overflow: unset;\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"currentColor\"><path d=\"M18.1675 8.33332C18.5481 10.2011 18.2769 12.1428 17.3991 13.8348C16.5213 15.5268 15.0899 16.8667 13.3438 17.6311C11.5976 18.3955 9.64221 18.5381 7.8036 18.0353C5.965 17.5325 4.35435 16.4145 3.24025 14.8678C2.12616 13.3212 1.57596 11.4394 1.68141 9.53615C1.78686 7.63294 2.54159 5.8234 3.81973 4.4093C5.09787 2.9952 6.82217 2.06202 8.70508 1.76537C10.588 1.46872 12.5157 1.82654 14.1667 2.77916\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><path d=\"M7.5 9.16659L10 11.6666L18.3333 3.33325\" stroke=\"#C1A57B\" stroke-width=\"1.66667\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\t\t\t\t\t<p class=\"paragraph-jakarta-16-400 e-bf2c76d-9fcffd5 e-paragraph-base\" data-interaction-id=\"bf2c76d\" data-e-type=\"widget\" data-id=\"1fe1kru\">Certificate of competence in radiation protection or application for SSIPM certificate of competence in radiation protection<\/p>\n\t\t\n<\/div>\n\n\t\t\n<\/div>\n\n<\/div>\n\n<\/div>\n\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-b81510b e-con e-atomic-element e-div-block-base background-soft-beige section-padding \" data-id=\"b81510b\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"b81510b\" data-e-type=\"e-div-block\" data-id=\"b81510b\">\n    <div class=\"elementor-element elementor-element-e1a2206 e-con e-atomic-element e-div-block-base padding-0 content-720 content-center \" data-id=\"e1a2206\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"e1a2206\" data-e-type=\"e-div-block\" data-id=\"e1a2206\">\n    <div class=\"elementor-element elementor-element-9fcbcef e-con e-atomic-element e-div-block-base content-720 margin-bottom-12 padding-0 e-9fcbcef-bc3b28c \" data-id=\"9fcbcef\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"9fcbcef\" data-e-type=\"e-div-block\" data-id=\"9fcbcef\">\n    \t\t\t<p class=\"text-eyebrow e-715c2bd-d9094e8 e-paragraph-base\" data-interaction-id=\"715c2bd\" data-e-type=\"widget\" data-id=\"715c2bd\">ONLINE FORM<\/p>\n\t\t\t\t\t<h2 data-interaction-id=\"cfda698\" class=\"heading-jakarta-36-700 margin-bottom-12 e-heading-base\" data-e-type=\"widget\" data-id=\"cfda698\">Application for IDSP SSIPM<\/h2>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-9127d1d e-con e-atomic-element e-div-block-base content-center background-white border-blue-1-16 content-720 padding-64-44 \" data-id=\"9127d1d\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"9127d1d\" data-e-type=\"e-div-block\" data-id=\"9127d1d\">\n    <form class=\"e-con e-atomic-element e-form-base form-state-default flex-column-24 background-white padding-0 \"\n      data-id=\"e81cc58\"\n      data-element_type=\"e-form\"\n      data-e-type=\"e-form\"\n      data-interaction-id=\"e81cc58\"\n      data-interactions=\"null\"\n      x-data=\"eForme81cc58\"\n      x-on:submit=\"submit\"      aria-label=\"Form\"\n      data-form-name=\"Form\"\n            toolname=\"form_e81cc58\"\n      tooldescription=\"Submit&#x20;the&#x20;Form&#x20;form&#x20;with&#x20;the&#x20;provided&#x20;field&#x20;values.\">\n    \t\t\t<h2 data-interaction-id=\"6ad9e83\" class=\"heading-jakarta-18-700 e-6ad9e83-939927f e-heading-base\" data-e-type=\"widget\" data-id=\"6ad9e83\">Personal Details<\/h2>\n\t\t<div class=\"elementor-element elementor-element-8d41ed3 e-con e-atomic-element e-div-block-base padding-0 flex-row-20 e-8d41ed3-54ebf36 \" data-id=\"8d41ed3\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"8d41ed3\" data-e-type=\"e-div-block\" data-id=\"8d41ed3\">\n    <div class=\"elementor-element elementor-element-bcd4e6f e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"bcd4e6f\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"bcd4e6f\" data-e-type=\"e-div-block\" data-id=\"bcd4e6f\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=personal-salutation\n\tdata-interaction-id=\"08aa848\"\n\tdata-e-type=\"widget\" data-id=\"08aa848\"\n\t\n>Title *<\/label>\n\t\t\t\t\t<select \n\tid=personal-salutation\n\tname=personal-salutation\n\tclass=\"border-blue-1-12 e-form-select-base\"\n\tdata-interaction-id=\"c53b36a\"\n\tdata-e-type=\"widget\" data-id=\"c53b36a\" \n\t\n\trequired\n\t\n>\n\t\t\t<option value=\"Mann\">M\u00e4nnlich<\/option>\n\t\t\t<option value=\"Frau\">Weiblich<\/option>\n\t\t\t<option value=\"Divers\">Divers<\/option>\n\t<\/select>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-0330ab6 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"0330ab6\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"0330ab6\" data-e-type=\"e-div-block\" data-id=\"0330ab6\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=personal-academic-title\n\tdata-interaction-id=\"d3ea366\"\n\tdata-e-type=\"widget\" data-id=\"d3ea366\"\n\t\n>Academic title *<\/label>\n\t\t\t\t\t<input \n\tid=personal-academic-title\n\tname=personal-academic-title\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"855c75b\"\n\tdata-e-type=\"widget\" data-id=\"855c75b\" \n\t\n\tplaceholder=e.g.,&#x20;Dr.&#x20;med.\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-62d1d4f e-con e-atomic-element e-div-block-base padding-0 flex-row-20 e-62d1d4f-b62ceb2 \" data-id=\"62d1d4f\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"62d1d4f\" data-e-type=\"e-div-block\" data-id=\"62d1d4f\">\n    <div class=\"elementor-element elementor-element-f90325a e-con e-atomic-element e-div-block-base padding-0 \" data-id=\"f90325a\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"f90325a\" data-e-type=\"e-div-block\" data-id=\"f90325a\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=personal-first-name\n\tdata-interaction-id=\"115e604\"\n\tdata-e-type=\"widget\" data-id=\"115e604\"\n\t\n>First name *<\/label>\n\t\t\t\t\t<input \n\tid=personal-first-name\n\tname=personal-first-name\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"2e55f9c\"\n\tdata-e-type=\"widget\" data-id=\"2e55f9c\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-549652d e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"549652d\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"549652d\" data-e-type=\"e-div-block\" data-id=\"549652d\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=personal-last-name\n\tdata-interaction-id=\"c6835be\"\n\tdata-e-type=\"widget\" data-id=\"c6835be\"\n\t\n>Last name *<\/label>\n\t\t\t\t\t<input \n\tid=personal-last-name\n\tname=personal-last-name\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"00267bd\"\n\tdata-e-type=\"widget\" data-id=\"00267bd\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-4ab9ab8 e-con e-atomic-element e-div-block-base padding-0 e-4ab9ab8-a72fb65 flex-row-20 \" data-id=\"4ab9ab8\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"4ab9ab8\" data-e-type=\"e-div-block\" data-id=\"4ab9ab8\">\n    <div class=\"elementor-element elementor-element-e32e14a e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"e32e14a\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"e32e14a\" data-e-type=\"e-div-block\" data-id=\"e32e14a\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=personal-birthday\n\tdata-interaction-id=\"e0722e8\"\n\tdata-e-type=\"widget\" data-id=\"e0722e8\"\n\t\n>Date of birth *<\/label>\n\t\t\t\t\t<input \n\tid=personal-birthday\n\tname=personal-birthday\n\tclass=\"border-blue-1-12 e-3f28347-18840d6 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"3f28347\"\n\tdata-e-type=\"widget\" data-id=\"3f28347\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-bc4b7b7 e-con e-atomic-element e-div-block-base flex-column-12 padding-0 \" data-id=\"bc4b7b7\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"bc4b7b7\" data-e-type=\"e-div-block\" data-id=\"bc4b7b7\">\n    \t\t\t<span class=\"heading-inter-14-500 e-c877d96-ab1705e e-paragraph-base\" data-interaction-id=\"c877d96\" data-e-type=\"widget\" data-id=\"c877d96\">Preferred contact *<\/span>\n\t\t<div class=\"elementor-element elementor-element-96d5b91 e-con e-atomic-element e-div-block-base padding-0 flex-column-20 \" data-id=\"96d5b91\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"96d5b91\" data-e-type=\"e-div-block\" data-id=\"96d5b91\">\n    <div class=\"elementor-element elementor-element-198b5dc e-con e-atomic-element e-div-block-base padding-0 flex-column-center flex-row-8 \" data-id=\"198b5dc\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"198b5dc\" data-e-type=\"e-div-block\" data-id=\"198b5dc\">\n    \t\t\t<input \n\tid=preferred-contact-privat\n\tname=Bevorzugter&amp;#x20;Kontakt\n\tvalue=Privat\n\tclass=\"border-blue-1-12 e-form-radio-button-base\"\n\ttype=\"radio\"\n\tdata-interaction-id=\"1162ebd\"\n\tdata-e-type=\"widget\" data-id=\"1162ebd\" \n\t\n\trequired\n\t\n\/>\n\t\t\t\t\t<label \n\t\n\tclass=\"e-form-label-base\"\n\tfor=preferred-contact-privat\n\tdata-interaction-id=\"ee08d86\"\n\tdata-e-type=\"widget\" data-id=\"ee08d86\"\n\t\n>Private<\/label>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-cd6a70f e-con e-atomic-element e-div-block-base padding-0 flex-column-center flex-row-8 \" data-id=\"cd6a70f\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"cd6a70f\" data-e-type=\"e-div-block\" data-id=\"cd6a70f\">\n    \t\t\t<input \n\tid=preferred-contact-hospital\n\tname=Bevorzugter&amp;#x20;Kontakt\n\tvalue=Praxis,&amp;#x20;Spital,&amp;#x20;Institut\n\tclass=\"border-blue-1-12 e-form-radio-button-base\"\n\ttype=\"radio\"\n\tdata-interaction-id=\"0b3ed4a\"\n\tdata-e-type=\"widget\" data-id=\"0b3ed4a\" \n\t\n\trequired\n\t\n\/>\n\t\t\t\t\t<label \n\t\n\tclass=\"e-form-label-base\"\n\tfor=preferred-contact-hospital\n\tdata-interaction-id=\"b4648a9\"\n\tdata-e-type=\"widget\" data-id=\"b4648a9\"\n\t\n>Practice, hospital, institute<\/label>\n\t\t\n<\/div>\n\n<\/div>\n\n<\/div>\n\t\t\t<h2 data-interaction-id=\"3d60958\" class=\"heading-jakarta-18-700 margin-top-32 e-3d60958-ca5d263 e-heading-base\" data-e-type=\"widget\" data-id=\"3d60958\">Private address<\/h2>\n\t\t<div class=\"elementor-element elementor-element-14545d9 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"14545d9\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"14545d9\" data-e-type=\"e-div-block\" data-id=\"14545d9\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=home-address-street\n\tdata-interaction-id=\"aea8278\"\n\tdata-e-type=\"widget\" data-id=\"aea8278\"\n\t\n>Street *<\/label>\n\t\t\t\t\t<input \n\tid=home-address-street\n\tname=home-address-street\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"b14b373\"\n\tdata-e-type=\"widget\" data-id=\"b14b373\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=on\n\/>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-bbb7f0d e-con e-atomic-element e-div-block-base padding-0 flex-row-20 e-bbb7f0d-18e77f4 \" data-id=\"bbb7f0d\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"bbb7f0d\" data-e-type=\"e-div-block\" data-id=\"bbb7f0d\">\n    <div class=\"elementor-element elementor-element-6801948 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"6801948\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"6801948\" data-e-type=\"e-div-block\" data-id=\"6801948\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=home-address-postal-code\n\tdata-interaction-id=\"1ef8591\"\n\tdata-e-type=\"widget\" data-id=\"1ef8591\"\n\t\n>Postal code *<\/label>\n\t\t\t\t\t<input \n\tid=home-address-postal-code\n\tname=home-address-postal-code\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"number\"\n\tdata-interaction-id=\"ec4a05b\"\n\tdata-e-type=\"widget\" data-id=\"ec4a05b\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-5ba65ed e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"5ba65ed\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"5ba65ed\" data-e-type=\"e-div-block\" data-id=\"5ba65ed\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=home-address-city\n\tdata-interaction-id=\"4ced2be\"\n\tdata-e-type=\"widget\" data-id=\"4ced2be\"\n\t\n>City *<\/label>\n\t\t\t\t\t<input \n\tid=home-address-city\n\tname=home-address-city\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"5f0b324\"\n\tdata-e-type=\"widget\" data-id=\"5f0b324\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-1a50986 e-con e-atomic-element e-div-block-base padding-0 flex-row-20 e-1a50986-a4aa181 \" data-id=\"1a50986\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"1a50986\" data-e-type=\"e-div-block\" data-id=\"1a50986\">\n    <div class=\"elementor-element elementor-element-dc71077 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"dc71077\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"dc71077\" data-e-type=\"e-div-block\" data-id=\"dc71077\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=home-address-mobile-number\n\tdata-interaction-id=\"7551735\"\n\tdata-e-type=\"widget\" data-id=\"7551735\"\n\t\n>Mobile number *<\/label>\n\t\t\t\t\t<input \n\tid=home-address-mobile-number\n\tname=home-address-mobile-number\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"tel\"\n\tdata-interaction-id=\"e3327fe\"\n\tdata-e-type=\"widget\" data-id=\"e3327fe\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-0c06300 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"0c06300\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"0c06300\" data-e-type=\"e-div-block\" data-id=\"0c06300\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=home-address-email-address\n\tdata-interaction-id=\"38bfefb\"\n\tdata-e-type=\"widget\" data-id=\"38bfefb\"\n\t\n>Email address *<\/label>\n\t\t\t\t\t<input \n\tid=home-address-email-address\n\tname=home-address-email-address\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"email\"\n\tdata-interaction-id=\"344e8da\"\n\tdata-e-type=\"widget\" data-id=\"344e8da\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n\n<\/div>\n\t\t\t<h2 data-interaction-id=\"98a9932\" class=\"heading-jakarta-18-700 margin-top-32 e-98a9932-a3f449d e-heading-base\" data-e-type=\"widget\" data-id=\"98a9932\">Practice \/ Hospital \/ Institute<\/h2>\n\t\t<div class=\"elementor-element elementor-element-30dc169 e-con e-atomic-element e-div-block-base padding-0 flex-row-20 e-30dc169-eef079a \" data-id=\"30dc169\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"30dc169\" data-e-type=\"e-div-block\" data-id=\"30dc169\">\n    <div class=\"elementor-element elementor-element-019a32c e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"019a32c\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"019a32c\" data-e-type=\"e-div-block\" data-id=\"019a32c\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=institution-name\n\tdata-interaction-id=\"8a34662\"\n\tdata-e-type=\"widget\" data-id=\"8a34662\"\n\t\n>Name of practice\/institute\/hospital *<\/label>\n\t\t\t\t\t<input \n\tid=institution-name\n\tname=institution-name\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"248f3fb\"\n\tdata-e-type=\"widget\" data-id=\"248f3fb\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-4e007c9 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"4e007c9\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"4e007c9\" data-e-type=\"e-div-block\" data-id=\"4e007c9\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=institution-position\n\tdata-interaction-id=\"4e4bf6f\"\n\tdata-e-type=\"widget\" data-id=\"4e4bf6f\"\n\t\n>Position<\/label>\n\t\t\t\t\t<input \n\tid=institution-position\n\tname=institution-position\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"57a6a3a\"\n\tdata-e-type=\"widget\" data-id=\"57a6a3a\" \n\t\n\t\n\t\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-7feb466 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"7feb466\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"7feb466\" data-e-type=\"e-div-block\" data-id=\"7feb466\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=institution-street\n\tdata-interaction-id=\"56d4634\"\n\tdata-e-type=\"widget\" data-id=\"56d4634\"\n\t\n>Street *<\/label>\n\t\t\t\t\t<input \n\tid=institution-street\n\tname=institution-street\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"33796fd\"\n\tdata-e-type=\"widget\" data-id=\"33796fd\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-7c0efaa e-con e-atomic-element e-div-block-base padding-0 flex-row-20 e-7c0efaa-da49152 \" data-id=\"7c0efaa\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"7c0efaa\" data-e-type=\"e-div-block\" data-id=\"7c0efaa\">\n    <div class=\"elementor-element elementor-element-330ae7f e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"330ae7f\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"330ae7f\" data-e-type=\"e-div-block\" data-id=\"330ae7f\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=institution-postal-code\n\tdata-interaction-id=\"9d7fffc\"\n\tdata-e-type=\"widget\" data-id=\"9d7fffc\"\n\t\n>Postal code *<\/label>\n\t\t\t\t\t<input \n\tid=institution-postal-code\n\tname=institution-postal-code\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"number\"\n\tdata-interaction-id=\"72c167e\"\n\tdata-e-type=\"widget\" data-id=\"72c167e\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-f41174c e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"f41174c\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"f41174c\" data-e-type=\"e-div-block\" data-id=\"f41174c\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=institution-city\n\tdata-interaction-id=\"6d9b028\"\n\tdata-e-type=\"widget\" data-id=\"6d9b028\"\n\t\n>City *<\/label>\n\t\t\t\t\t<input \n\tid=institution-city\n\tname=institution-city\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"text\"\n\tdata-interaction-id=\"15582d6\"\n\tdata-e-type=\"widget\" data-id=\"15582d6\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-e7b35ae e-con e-atomic-element e-div-block-base padding-0 flex-row-20 e-e7b35ae-9c15d92 \" data-id=\"e7b35ae\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"e7b35ae\" data-e-type=\"e-div-block\" data-id=\"e7b35ae\">\n    <div class=\"elementor-element elementor-element-0c48f27 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"0c48f27\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"0c48f27\" data-e-type=\"e-div-block\" data-id=\"0c48f27\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=institution-direct-phone-number\n\tdata-interaction-id=\"9dba5e3\"\n\tdata-e-type=\"widget\" data-id=\"9dba5e3\"\n\t\n>Phone number (direct) *<\/label>\n\t\t\t\t\t<input \n\tid=institution-direct-phone-number\n\tname=institution-direct-phone-number\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"tel\"\n\tdata-interaction-id=\"4c760e4\"\n\tdata-e-type=\"widget\" data-id=\"4c760e4\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-c60490d e-con e-atomic-element e-div-block-base padding-0 flex-column-12 \" data-id=\"c60490d\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"c60490d\" data-e-type=\"e-div-block\" data-id=\"c60490d\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=institution-email-address\n\tdata-interaction-id=\"9c788c7\"\n\tdata-e-type=\"widget\" data-id=\"9c788c7\"\n\t\n>Email address *<\/label>\n\t\t\t\t\t<input \n\tid=institution-email-address\n\tname=institution-email-address\n\tclass=\"border-blue-1-12 e-form-input-base\"\n\ttype=\"email\"\n\tdata-interaction-id=\"b0eae38\"\n\tdata-e-type=\"widget\" data-id=\"b0eae38\" \n\t\n\t\n\trequired\n\t\n\tautocomplete=off\n\/>\n\t\t\n<\/div>\n\n<\/div>\n\t\t\t<h2 data-interaction-id=\"bd21dd0\" class=\"heading-jakarta-18-700 margin-top-32 e-bd21dd0-bb299b2 e-heading-base\" data-e-type=\"widget\" data-id=\"bd21dd0\">Upload documents<\/h2>\n\t\t<div class=\"elementor-element elementor-element-d06aad2 e-con e-atomic-element e-div-block-base padding-0 flex-column-24 \" data-id=\"d06aad2\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"d06aad2\" data-e-type=\"e-div-block\" data-id=\"d06aad2\">\n    <div class=\"elementor-element elementor-element-c298660 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 e-c298660-2e4acf8 \" data-id=\"c298660\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"c298660\" data-e-type=\"e-div-block\" data-id=\"c298660\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=file-upload-application-form\n\tdata-interaction-id=\"6a5e7c6\"\n\tdata-e-type=\"widget\" data-id=\"6a5e7c6\"\n\t\n>Completed application form *<\/label>\n\t\t<div class=\"elementor-element elementor-element-aef76c5 e-con e-atomic-element e-div-block-base e-aef76c5-40e654d flex-row-center flex-row-12 \" data-id=\"aef76c5\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"aef76c5\" data-e-type=\"e-div-block\" data-id=\"aef76c5\">\n    \t\t\t<input\n\tid=file-upload-application-form\n\tname=file-upload-application-form\n\tclass=\"e-fc01794-d0af038 e-form-file-upload-base\"\n\ttype=\"file\"\n\tdata-interaction-id=\"fc01794\"\n\tdata-max-file-size=\"10\"\n\tdata-max-files=\"1\"\n\tdata-attachment-type=\"attach\"\n\tdata-e-type=\"widget\" data-id=\"fc01794\"\n\t\n\taccept=pdf\n\trequired\n\t\n\/>\n\t\t\t\t\t<p class=\"paragraph-inter-14-400 e-1b5da78-96762a3 e-paragraph-base\" data-interaction-id=\"1b5da78\" data-e-type=\"widget\" data-id=\"1b5da78\">Upload file (PDF, max. 10 MB)<\/p>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-2c50a62 e-con e-atomic-element e-div-block-base padding-0 flex-column-12 e-2c50a62-be4cdcd \" data-id=\"2c50a62\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"2c50a62\" data-e-type=\"e-div-block\" data-id=\"2c50a62\">\n    \t\t\t<label \n\t\n\tclass=\"heading-jakarta-14-500 e-form-label-base\"\n\tfor=file-upload-confirmation-of-participation\n\tdata-interaction-id=\"540e917\"\n\tdata-e-type=\"widget\" data-id=\"540e917\"\n\t\n>Certificates of attendance<\/label>\n\t\t<div class=\"elementor-element elementor-element-7cc0f6d e-con e-atomic-element e-div-block-base e-7cc0f6d-4233aad flex-row-center flex-row-12 \" data-id=\"7cc0f6d\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"7cc0f6d\" data-e-type=\"e-div-block\" data-id=\"7cc0f6d\">\n    \t\t\t<input\n\tid=file-upload-confirmation-of-participation\n\tname=file-upload-confirmation-of-participation\n\tclass=\"e-64cb41b-c3b3648 e-form-file-upload-base\"\n\ttype=\"file\"\n\tdata-interaction-id=\"64cb41b\"\n\tdata-max-file-size=\"10\"\n\tdata-max-files=\"1\"\n\tdata-attachment-type=\"attach\"\n\tdata-e-type=\"widget\" data-id=\"64cb41b\"\n\t\n\taccept=pdf\n\t\n\t\n\/>\n\t\t\t\t\t<p class=\"paragraph-inter-14-400 e-8f11833-ab1d02b e-paragraph-base\" data-interaction-id=\"8f11833\" data-e-type=\"widget\" data-id=\"8f11833\">Upload file (PDF, max. 10 MB)<\/p>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-455d670 e-con e-atomic-element e-div-block-base padding-0 \" data-id=\"455d670\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"455d670\" data-e-type=\"e-div-block\" data-id=\"455d670\">\n    \t\t\t<label \n\t\n\tclass=\"e-form-label-base\"\n\tfor=comments\n\tdata-interaction-id=\"60bba89\"\n\tdata-e-type=\"widget\" data-id=\"60bba89\"\n\t\n>Comments<\/label>\n\t\t\t\t\t<textarea\t\n\tid=comments\n\tname=comments\n\tclass=\"border-blue-1-12 e-form-textarea-base\"\n\tdata-interaction-id=\"9a380c6\"\n\tdata-e-type=\"widget\" data-id=\"9a380c6\"\n\t\n\t\n\t\n\t\n\trows=4\n\t\n\t\n\tdata-resizable\n><\/textarea>\n\t\t\n<\/div>\n\n<\/div>\n<div class=\"elementor-element elementor-element-2783d4f e-con e-atomic-element e-div-block-base padding-0 e-2783d4f-4eb026d \" data-id=\"2783d4f\" data-element_type=\"e-div-block\" data-e-type=\"e-div-block\" data-interaction-id=\"2783d4f\" data-e-type=\"e-div-block\" data-id=\"2783d4f\">\n    \t\t\t<button \n\tid=button-einreichen\n\tclass=\"radius-9999 e-form-submit-button-base\"\n\ttype=\"submit\"\n\tdata-interaction-id=\"d92f12c\"\n\tdata-e-type=\"widget\" data-id=\"d92f12c\"\n\t\n>Submit<\/button>\n\t\t\n<\/div>\n<div class=\"e-con e-atomic-element e-form-success-message-base message-success \"\n     tabindex=\"-1\"\n     data-id=\"5b58926\"\n     data-element_type=\"e-form-success-message\"\n     data-e-type=\"e-form-success-message\"\n     data-interaction-id=\"5b58926\"\n     aria-live=\"polite\"\n     >\n    \t\t\t<p class=\"paragraph-inter-14-400 e-29995d0-7b96f72 e-paragraph-base\" data-interaction-id=\"29995d0\" data-e-type=\"widget\" data-id=\"29995d0\">Great! We have received your information. <\/p>\n\t\t\n<\/div>\n<div class=\"e-con e-atomic-element e-form-error-message-base message-error \"\n     tabindex=\"-1\"\n     data-id=\"16211e7\"\n     data-element_type=\"e-form-error-message\"\n     data-e-type=\"e-form-error-message\"\n     data-interaction-id=\"16211e7\"\n     role=\"alert\"\n     >\n    \t\t\t<p class=\"paragraph-inter-14-400 e-6791d4d-3f41bba e-paragraph-base\" data-interaction-id=\"6791d4d\" data-e-type=\"widget\" data-id=\"6791d4d\">We could not process your submission. 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