Thank you for your interest in a patient (including caregivers) scholarship at the Society for Medical Decision Making’s 40th Annual Meeting in Montreal, Quebec, Canada. Please complete this form by the deadline of Friday, June 29, 2018 so that we may consider your application.

Patient (including caregivers) scholarships cover economy travel to and from Montreal, three nights’ hotel stay (or more nights if required due to travel needs), registration at the conference and funds to cover meals (called a per diem). These costs will be paid in advance. Travel will be booked through a travel agent by the Society. During the conference, there will be places and opportunities to rest.

Scholarship recipients will be selected by a committee of people involved in planning the meeting, including two Patient Partner meeting co-chairs. All committee members will recuse themselves from deliberations in cases in which there is a real or potential perceived conflict of interest. (In other words, if we know you, we won’t be involved in assessing your application and won’t be able to influence the decision in any way.)

Scholarships will be awarded based on applicants’ demonstrated interest in medical decision making research, willingness and ability to disseminate what they learned to their community or communities, and representation across age, gender, race/ethnicity, socioeconomic status, and geographical location.

All information provided here will remain confidential. If you are selected for a patient scholarship, the only information that will be shared publicly will be: your name, where you live, and any public social media accounts you hold. Your social media handles/accounts and posts will only be shared publicly with your approval.

While at the conference, you will also be invited to attend an optional daily meeting with other patients/patient advocates to share your experiences.

After the conference, you will be asked to complete a survey regarding your experience at the meeting and you may be asked to participate in an optional meeting or conference call with conference chairs to discuss your experience.

Therapy animals are permitted in all places in connection with the conference; however, they must be accompanied by appropriate documents and must be registered with SMDM prior to the scholarship recipient’s arrival at the conference.

Scholarship determinations will be made in mid-August 2018 and all applicants will be notified of their scholarship status via the e-mail address submitted with the scholarship application.