Abstract-Submission-Form

Abstract Submission Form

SECTION 1: PRESENTER INFORMATION

Presenting Author Surname
Presenting Author Given Name
Presenting Author Degree(s) (e.g., PhD, MD, CHT, etc.)
Contact Email
Re-enter Email
Contact Phone (Country code)(Area code)(Phone)
Additional Authors
(Given Name Surname for each separated by commas – or “none”)
Participating Institutions
(Institution, Address, Postcode)

SECTION 2: ABSTRACT INFORMATION
Title of Abstract Exactly as on abstract
Arena Clinical Basic Science
Content Research Report Topic Review
Category Placement

SECTION 3: FILE UPLOAD

Requirements for the presentation abstract document:

  • Must include Hypothesis, Method, Results, and Summary.
  • May also include up to 2 embedded images.
  • MS Word format (.doc or .docx).
  • Font size must be 12 point or larger.
  • The entire document (including images) must fit on one side of one A4 page.

These requirements are strict. Submissions not meeting these specifications will be returned.
Please review requirements outlined here for additional information.
Attach File to Upload
(Click the “browse” or “choose file” button, locate your abstract,
click “open”)
  Reminder: only MS Word formats will be accepted
Comments
(Optional)
Replace Prior Abstract No Yes
Check ‘Yes’ for any abstract you previously submitted to be replaced by this one. Checking ‘Yes’ means that all prior submissions will be removed. Checking ‘No’ means that an additional file will be submitted for separate consideration.

Section 4: Conflict of Interest

For each author, list any commercial interest or interaction, or state “None”

Section 5: Confirmation
RSVP: I will register as soon as registration opens: Yes No.
Please hold seat(s) for me and additional authors until March 15, 2015.
I agree that accepted abstracts will be posted on this web site and available to the public for Internet viewing and printing in the conference proceedings. If my abstract is accepted I agree to register for the conference, and attend the conference to present in oral or poster session as selected by the Scientific Advisory Board. I agree that my presentation will be video-taped and made available on the Internet. I understand the Scientific Advisory Board has the final determination for assigned category for accepted abstracts.

 

Questions or difficulty using this form? Contact c.eaton.md@dupuytrens.org.

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