American Academy of Physician Assistants
2009 Clinical and Professional Poster Session Abstract Submission Application
All abstract submission forms must be received by 11:59 p.m. EST on Wednesday, January 7, 2009.
SUBMISSION INFORMATION
Submitting Author
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STUDENT AFFILIATION
If you are currently enrolled in an entry-level accredited PA program, please complete the information below.
Program Name
Program Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
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Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
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New York
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Ohio
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South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
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West Virginia
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Wyoming
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Program Director's Name
AUTHOR INFORMATION
Authorship is substantial participation, which includes involvement of the conception and design, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of version to be published. Authorship is not acceptable if the author only provides encouragement, physical facilities, financial support, critiques or editorial contributions.
First Author's Name
AAPA #
Membership Status
Member
Non-Member
Second Author's Name
AAPA #
Membership Status
Member
Non-Member
Third Author's Name
AAPA #
Membership Status
Member
Non-Member
Fourth Author's Name
AAPA #
Membership Status
Member
Non-Member
Fifth Author's Name
AAPA #
Membership Status
Member
Non-Member
ABSTRACT CATEGORY SELECTION
Click here for Category Definitions
Select Only One
Original Research
Education Research
Case Studies/Clinical Reports
Curricular Innovations
Previously Presented
If previously presented, where?
Was work completed while in a postgraduate training program?
Is this student research on or about postgraduate education/training?
GALLERY SELECTION
Click here for Gallery Definitions
Select Only One
Clinical and Professional Gallery
Education Gallery
Student Gallery
ABSTRACT INFORMATION
Title
Keyword Search Option
Please provide (3) words that best suit the topic of your research, i.e., tracheotomy, HIV, education, etc.
1.
2.
3.
Instructions for Attaching Abstract
Please exclude the name and affiliation of the authors when submitting your research.
NOTE: Abstracts can be cut and pasted into the space below or attached in Word document format.
To attach or upload file click browse. (Please note: 500 word limit)
Warning: Not all browsers support file upload capabilities. Recent versions of Microsoft (4.0 and greater), Netscape (3.0 and greater), and AOL (4.0 and greater) support this feature. If you are not using a recent browser, please copy your abstract text in the box provided below.
DISCLOSURE POLICY AND DECLARATION STATEMENTS
Declaration is intended to protect all parties involved from any potential conflict that may arise from the presentation. The announcement of affiliations or financial arrangements gives participants full disclosure of facts from which they may form their own judgments. If you and/or any of the co-authors have received funding in support or sponsorship of your research, please provide the necessary information below.
Submitting Author's Name
NON-DECLARATION STATEMENT
By clicking here
I declare that neither I, nor any immediate family member, have a current affiliation or financial arrangement with the grantor and/or any organization(s) that may have a direct interest in the subject matter of the above stated program.
DECLARATION STATEMENT
By clicking here
I declare that either I, or my immediate family member, currently have an affiliation or financial arrangement with the grantor and/or any organization(s) that may have a direct interest in the subject matter of the above-mentioned program.
Funding Types
Honorarium
Consultant
Grants/Research Support
Stock Shareholder
Other Financial/Material Support
Speakers' Bureau
Employee
Other
ABSTRACT ACKNOWLEDGEMENT
Once you have successfully completed the submission application you will receive an e-mail of the results submitted, confirming receipt. Please re-type your e-mail address below. If you have not received confirmation in 24 hours, please contact Cheryl Holmes, clinical affairs and education, cholmes@aapa.org or 703/836-2272, ext. 3419.