Poster
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Ohio Chapter, American Academy of Pediatrics
2012 Annual Meeting
Poster Submission Form

Thank you for your submission, you will be notified by July 20, 2012.

Ohio AAP contact for all questions: Elizabeth Dawson, 614-846-6258 or edawson@ohioaap.org

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1. Please enter your contact information.

Please enter your contact information. Name:
E-mail:
Address:
Practice/Hospital Name:
Phone:
Fax:

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2. Poster Name:

Poster Name:

3. In this space provided below, please provide poster/program description that includes an overview of implementation and any outcomes of this effort (please limit your response to 300 words).

In this space provided below, please provide poster/program description that includes an overview of implementation and any outcomes of this effort (please limit your response to 300 words).

PosterExit this survey

*1. Please enter your contact information.

*2. Poster Name:

3. In this space provided below, please provide poster/program description that includes an overview of implementation and any outcomes of this effort (please limit your response to 300 words).

Poster
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1. Please enter your contact information.

*
2. Poster Name: