34th (2009) Annual Conference Information



Submit an Abstract
(Online)

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*EDUCATIONAL FORMAT: Select only one (1) format.


*TITLE: Type in the title.
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*THEME: Select only one (1) theme related area:

or

Area not related to theme:

Other (specify):
Describe in five words or less.
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*COMPETENCY: Select only one (1) competency.


*PRINCIPAL PRESENTER:

Type in first name, last name, a comma, and only one (1) degree or one (1) credential.
*Organization:

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*Telephone:

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*E-mail:

Type in only one (1) address.
*Disclosure:
Disclose whether this individual does or does not have an interest (e.g., owner, employee, etc.) in selling (e.g., producing, marketing, distributing, etc.) a technology, program, product, and/or service to CME professionals (see below and Example in Call for Educational Abstracts).
I do not have an interest in selling a technology, program, product, and/or service to CME professionals.
or
I do have an interest in selling a technology, program, product, and/or service to CME professionals, indicating all that are applicable.
Technology, e.g., pod cast
Program, e.g., online education
Product, e.g., outcomes model/plan
Service, e.g., consulting


CO-PRESENTER:

Type in first name, last name, a comma, and only one (1) degree or one (1) credential.
Organization:

Type in only one (1) name.
Telephone:

Type in only one (1) number.
E-mail:

Type in only one (1) address.
Disclosure:
Disclose whether this individual does or does not have an interest (e.g., owner, employee, etc.) in selling (e.g., producing, marketing, distributing, etc.) a technology, program, product, and/or service to CME professionals (see below and Example in Call for Educational Abstracts).
I do not have an interest in selling a technology, program, product, and/or service to CME professionals.
or
I do have an interest in selling a technology, program, product, and/or service to CME professionals, indicating all that are applicable. 
Technology, e.g., pod cast
Program, e.g., online education
Product, e.g., outcomes model/plan
Service, e.g., consulting


CO-PRESENTER:
Type in first name, last name, a comma, and only one (1) degree or one (1) credential.
Organization:

Type in only one (1) name.
Telephone:

Type in only one (1) number.
E-mail:

Type in only one (1) address.
Disclosure:
Disclose whether this individual does or does not have an interest (e.g., owner, employee, etc.) in selling (e.g., producing, marketing, distributing, etc.) a technology, program, product, and/or service to CME professionals (see below and Example in Call for Educational Abstracts).
I do not have an interest in selling a technology, program, product, and/or service to CME professionals.
or
I do have an interest in selling a technology, program, product, and/or service to CME professionals, indicating all that are applicable.
Technology, e.g., pod cast
Program, e.g., online education
Product, e.g., outcomes model/plan
Service, e.g., consulting


CO-PRESENTER:

Type in first name, last name, a comma, and only one (1) degree or one (1) credential.
Organization:

Type in only one (1) name.
Telephone:
Type in only one (1) number.
E-mail:

Type in only one (1) address.
Disclosure:
Disclose whether this individual does or does not have an interest (e.g., owner, employee, etc.) in selling (e.g., producing, marketing, distributing, etc.) a technology, program, product, and/or service to CME professionals (see below and Example in Call for Educational Abstracts).
I do not have an interest in selling a technology, program, product, and/or service to CME professionals.
or
I do have an interest in selling a technology, program, product, and/or service to CME professionals, indicating all that are applicable.
Technology, e.g., pod cast
Program, e.g., online education
Product, e.g., outcomes model/plan
Service, e.g., consulting



TARGET AUDIENCE: Select.
*Only one (1) experience level.
Beginners
      
Non-beginners    


*All member sections or one (1) applicable member section.
All member sections
 or Federal Health Care Educators
Health Care Education Associations
Hospitals and Health Systems
Medical Education and Communication Company Alliance (MECCA)
Medical Schools
Medical Specialty Societies
Pharmaceutical Alliance for CME (PACME)
State Medical Societies


*OBJECTIVES: Outline.
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*METHODS: Describe.
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*KEY POINTS: Summarize.
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(Optional) RECOMMENDED READING: Include.
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(If Applicable) Financial and/or In-kind Support: List.
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Please print a copy of this form for your records before submitting.





If you experience a problem with the online submission and do not receive a
“successfully submitted” message, please immediately contact Diane Baker
(205/453-0445) for further instructions.