Thank you for your interest in speaking at the 2018 Practice Management Program. Please complete the form below.

* First Name:

* Last Name:

* Email Address:

* Session Type:

* Content Focus:

* Session Title:

* Session Description:

* Briefly outline session objective(s) and/or provide an outline for the session:

* Briefly describe your clinical practice and/or experience on this topic:

* Target Audience: (Select all that apply):

* Do you have at least 2+ years’ experience in pharmacy practice management in a hospital system or community-based setting required (oncology pharmacy practice management experience preferred)?

* Briefly describe your practice experience:

* Do you have speaking experience at 2 or more regional or national conferences?

* Please upload your CV.

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