For each poster abstract/project submission, questions 1-15 are required only.  If the poster abstract/project has co-authors, then questions 16-22 should be completed as well.  

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* 1. What is the title of your improvement or innovation project? Title should be concise, applicable & prominently displayed on your poster.

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* 2. Statement of Purpose/Clinical Question:

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* 3. Innovative Idea/Innovation in Current Use:

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* 4. Framework (background and significance):

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* 5. Design Method:

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* 6. Setting/Sample Method:

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* 7. Protocol/Implementation Method:

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* 8. Findings/Results:

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* 9. Conclusions/Results:

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* 10. Please indicate your intention of the following submission requirement by selecting the applicable answer from the drop down menu.

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* 11. First & last name and credentials of primary presenter:

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* 12. Primary author's current title & employment affiliation.  If student, please indicate that in addition to the academic institution of enrollment.

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* 13. Email address for the primary author:

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* 14. Cell phone with area code for primary author:

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* 15. Mailing address of the primary author:

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* 16. Please include the first & last names and credentials of any other co-authors, if applicable.

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* 17. Email address for each of co-author:

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* 18. Please include a cell phone number for each of co-author of this improvement or innovation project.

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* 19. Please include the mailing address for each of co-author of this improvement or innovation project.

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