Submitter Information

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* 1. Submitter Name

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* 2. Degrees

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* 3. Email Address

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* 4. Will you be the presenter of this abstract?

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* 5. If you answered no, please list the name, credentials, and email address for the resident(s) presenting on your behalf:

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* 6. Please list the following details about your residency program:

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* 7. Please list the number of contributing authors to your research:

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* 8. Please select the abstract type you plan to present

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* 9. Presentation Title

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* 10. Purpose (please keep description to 500 words or less)

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* 11. Methods (please keep description to 500 words or less)

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* 12. Results (please keep description to 500 words or less)

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* 13. Conclusions (please keep description to 500 words or less)

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* 14. Please select the best topic area(s) that your research applies to:

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* 15. I confirm that I am training as a part of an accredited residency program and will not be presenting an abstract as a faculty member.

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* 16. I confirm that the work I am presenting is original research completed by the authors listed above.

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