Registration form

This is the online Pediatric Cardiac Center Contact Form. The purpose of this form is to enable the Centers to declare their access to the Database.

After registration, the system will generate the database ID for your Center. You will receive the registration confirmation in an automatic email answer.

Before registration, please read the Project About Project, which explains the aim of the data collectionand the Guidelines page to know how the data collection is organized.

After being registered please visit the Download section of our web site. You'll find there the software for data collection as well as the User's manuals containing necessary information about using the software.

Hospital type:
Hospital name:
Address:
Post code:
City:
Country:
Department name:
Department head:
Department phone:
Department fax:
Website:
Registering person:
Email:
Login:
Password:
CTSNet profile:
Repeat password:

On behalf of the CTS Center (as specified above, further referred to as the “CTS Center"), I hereby confirm that I have read the ECHSA Congenital Database Policy and I accept it.

I confirm that I am legally authorized to act on behalf of the CTS Center and, if necessary, on behalf of any larger healthcare establishment that the CTS Center may be organizational unit of, for the purpose of registration of the CTS Center in the ECHSA Congenital Database, and other actions connected with, and resulting from participation in the ECHSA Congenital Database project. I further confirm that the registration and the participation in the ECHSA Congenital Database comply with any local laws and internal procedures applicable to the CTS Center.

I hereby give consent to the processing of my personal data provided in this registration form by the ECHSA as a data controller for the purposes connected with the CTS Center's participation in the ECHSA Congenital Database project and the ECHSA' communication with the CTS Center. I acknowledge that the data submitted in the registration form may be verified by the ECHSA for its accuracy in publicly available information sources.

I am aware that I have the right to inspect and correct my personal data. I am also aware that although the provision of personal data is voluntary, it is necessary to register the CTS Center in the ECHSA Congenital Database.