Request to Present Abstract 2023

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* 1. First and Last Name

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* 2. Credentials

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* 3. Contact Info

Email Address

Phone Number

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* 4. Please share a short professional bio.

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* 5. Please upload a professional headshot.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 6. Please upload your CV.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 7. Please choose how you would like to present your topic:

Present orally only

Poster presentation only

Presenting either orally or with a poster is acceptable

Other (please specify)

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* 8. Please provide a short synopsis of the research you would like to present.

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* 9. Please upload your presentation for review.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 10. Photography/Videography Consent

I grant to National Lymphedema Network, its representatives, and employees the right to take photographs and/or video recordings of me and my property in connection with the 2023 National Lymphedema Conference 10/04/23-10/08/23.

I authorize the National Lymphedema Network, its assigns and transferees to copyright, use, and publish the same in print and/or electronically in publications, news releases, online, electronic newsletters, social media (such as Facebook and LinkedIn), and in other communications related to the National Lymphedema Network.

I agree that National Lymphedema Network may use such photographs and/or video recordings of me with or without my name as well as personal statements and personal information that I provided and for any lawful purpose, including, but not limited to, for purposes such as publicity, illustration, advertising, and web content for members of the National Lymphedema Network, and community education.

Yes

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* 11. I understand that my topic and presentation will be reviewed by the Scientific Committee to determine acceptance for participation in the 2023 NLN conference in Philadelphia, PA in October. I will be notified via email of approval.

Yes

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* 12. Please share any questions and/or comments here.

Thank you for your submission to present your research at the 2023 National Lymphedema Network. You will receive an email with further information and instructions if your abstract is chosen to be included in this year's program.