Lipid Clinic Network

Nomination form LCN – new clinics 2026

Nomination Form

This form is for current members of the EAS Lipid Clinic Network (LCN).

We invite you to nominate clinics and healthcare professionals in your country who could benefit from joining the network. This includes physicians, nurses, dietitians, and other healthcare professionals involved in the care of lipid patients.

Please provide the details for each nomination using the form below. Each clinic or colleague should be submitted as a separate nomination.

Your information

First Name

Last Name

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Nomination

First Name

Last Name

Title

Country

Phone/Mobile

Clinic Details

Some description about this section

Name of Clinic

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country