ADMSEP 2015 Presenters Application:  ABSTRACT Form
 [if you are instead looking for the the Disclosure-Biosketch form, go here.]. 


Contact info (required, first author only
, all presentions)
 
First Author      
Last Name Phone (e.g. 223-446-5000)
First Name Fax (e.g. 223-446-5000)
Title (MD, PhD, Ed.D. etc) Email
Institution Name:    
Street Address    
Address (cont)    
City/Province    
State    
Zip    
       
Is the first author a student or resident? Student  Resident    not applicable    

Additional Authors- please list the other persons involved in this project, in descending author order:
Last Name First Name Degree Institution Email


Abstract (required, first author only, all presentions)

Please note that submissions containing actual data, even if preliminary or anticipated, are preferred.  Please be sure to read the directions below, esp regarding abstract format choices, before entering your abstract body.
   
Type  
What kind of presentation are you submitting? (Tip) Plenary   Workshop   Discussion Group   Poster (Innovation)     Poster (Research)
   
This is the:   first time I have submitted this abstract    a revision
 
Abstract Title  

Abstract Body
Please provide your abstract body (including its educational objectives) in the box below. 
-Be sure to view and use one of the required abstract format choices when composing your submission. 
-Word count ≤ 350 (includes Title, Authors, Body, Objectives). 
-You may wish to consider composing your abstract in a word processing program first, e.g. Microsoft Word, save it on your local pc (as a safeguard), copy it and paste it in the box below.   Additionally, MS Word provides spell check, grammar check, and word count, unlike direct entry below.   The box below does not save images, charts, etc-- just text.
-CME Accreditation strongly recommends including at least 1-2 references.


  




WRAPPING IT UP

Optional:  Special note I wish to make at this time:


Important: 
-In all instances of form submission, always include your name in the "contact information" section at the top of the form! 

Prove you are not a robot spammer

Now click submit below
       


Please note:
-After clicking submit, you should see a web page which notes your responses; at this point you are done. 
-However, if you see that you made a mistake at the confirmation page, simply click the "back" button on your browser, make the correction(s), and click submit again (it will be clear from the timestamp which submission is your final version).  You do not have to reenter all the info just to correct a mistake as the form "remembers" what you put in previously.
-You should recieve a confirmation email which includes your submission content.
-After clicking submit, you may wish to procede to the Disclosure-Biosketch form.
-All relevant components must completed by all presentation participants by the deadline noted elsewhere

Questions/Help? 
-About the application process:   Dr. Gary Beck.
-If you have a question about the form itself, please contact webmaster.



r7/10/14