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ACOMS 14 Annual Residents Meeting Abstract Proposal Submission
Submitter Information
1.
Submitter Name
2.
Degrees
3.
Email Address
4.
Will you be the presenter of this abstract?
Yes
No
5.
If you answered no, please list the name, credentials, and email address for the resident(s) presenting on your behalf:
Name #1
Degrees #1
Email Address #1
Name #2
Degrees #2
Email Address #2
6.
Please list the following details about your residency program:
Program name
Program location
Your current year in the program
How many years are in your training program (4 or 6)
7.
Please list the number of contributing authors to your research:
8.
Please select the abstract type you plan to present
Oral Abstract (8 minutes of presentation, 2 minutes for questions)
Case Report (5 minutes of presentation, 2 minutes for questions)
My submission could be presented in either format
9.
Presentation Title
10.
Purpose (please keep description to 500 words or less)
11.
Methods (please keep description to 500 words or less)
12.
Results (please keep description to 500 words or less)
13.
Conclusions (please keep description to 500 words or less)
14.
Please select the best topic area(s) that your research applies to:
Anesthesia
TMJ Disorders/Facial Pain
Orthognathic
Sleep Apnea
Trauma
Dental Implants
Pathology
Oncology
Education/Training
Other (please specify)
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.
Yes
No
16.
I confirm that the work I am presenting is original research completed by the authors listed above.
Yes
No
Please specify any additional details here about the authors of your abstract that were not listed above if applicable: