Instructions

Use this submission form to submit Case Report abstracts. Case Report abstracts must include the following in the abstract submission: Introduction, Clinical Case Summary, Discussion, Lessons Learned.
  • Case Report submissions are expected to have received Institutional Review Board approval if any Protected Health Information is used or the case is potentially identifiable. Please attach approval document when appropriate.
  • An abstract may be submitted to one type of scholarly activity only.
  • Limit to 500 words. Letter Cambria and font size 11.
  • May attach tables, graphs, and images as a separate document.
  • Submit any questions to Alicia E. Adams, Esq., at aadams@fcaap.org.

Each pediatric residency program may send up to 5 residents to present abstracts. Each resident may only present one abstract. All submissions must be approved by the Program Director.

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* 1. Case Report Abstract Title:

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* 2. Full Names and Email Addresses for all Authors:

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* 3. Full Names and Email Addresses for all Mentors:

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* 4. Full Name, Email Address, and Phone Number of the Presenting Author:

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* 5. Presenting Author's Training Level:

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* 6. Upload your Case Report abstract.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 7. Upload the IRB approval letter, if appropriate, for your Case Report abstract.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 8. Upload any supporting tables/graphs/images.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 9. Upload any additional supporting tables/graphs/images.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 10. Program Name:

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* 11. Program Director's Name and Email Address:

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* 12. I certify that my Program Director (or his/her designee) has approved my submission of an abstract for presentation at the 2019 FCAAP Pediatric Resident Forum and has agreed to give me the time needed to travel to and present at the Forum.

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