*1.Your Information(Required.)

First Name

Last Name

Institutional Affiliation

Email Address

*2.Session Title(Required.)

*3.Please briefly describe the intended audience for your session(Required.)

*4.Please indicate your preferred session length(Required.)

2 hours

1/2 day

Full day

2 days

*5.Please indicate your preferred venue type(Required.)

50-70 participants (with tables)

71-100 participants (with tables)

107 participants (no tables)

130 participants (with tables)

350 participants (no tables) (Only available for full-day or half-day sessions)

*6.Please indicate your preferred session date (s)
Please note that scheduling will be done on a "first-come, first-served basis"(Required.)

Saturday, July 10th

Sunday, July 11th

Either July 10th or 11th / no preference

Both July 10th and 11th (for two-day sessions)

*7.Please describe your session format
(e.g. training workshop, mini-conference with open call for peer-review of abstracts, organized session, meeting, etc.)(Required.)

*8.Please indicate whether the session will be open to all delegates or closed, i.e., by invitation only. Please note that regardless of whether the pre-congress session is open to all delegates or by invitation only, the organizers may not charge delegates for their participation.(Required.)

Open

Closed

*9.Please provide a brief description of the session - this will be used to assess the proposed session, and if accepted, will be posted on the Congress website and in the program (max. 100 words).(Required.)

*10.Please provide details of person who should be sent the session invoice(Required.)

Name

Organization

Email Address

Phone Number

11.Please provide any additional information about your proposed session.

I understand that a conflict of interest refers to a financial or non-financial relationship that could influence, or appear to influence, the extent to which the research that will be presented during this pre-congress session was conducted in an impartial and objective way. Disclosure represents a commitment to transparency and does not necessarily indicate a bias.

It is particularly important to consider the funding sources for the research to be presented and for the session as a whole. Funding by any organization whose products can harm health or a for-profit company advocating for increased use of their health products or services should be declared, including where funding is via a third-party organization such as a foundation.

I recognize that if we fail to declare a conflict of interest while submitting this application, our pre-congress session can be withdrawn by IHEA at any stage.

12.Are there any conflicts of interest related to this pre-congress session?

Yes

No

13.If yes, please declare the name(s) of the organization(s) and describe the nature of their relationship with the session organizers, likely presenters and/or research that will be presented.