2024 Coastal Emergency Medicine Conference - Course Proposal Form

We welcome your proposals for the 2024 Coastal Emergency Medicine Conference. Proposals will be reviewed by the planning committee and our program chair will contact all submitters. The 2024 CEMC Conference is Thursday, June 6 - Saturday, June 8.

NOTE: This is a new lecture date pattern than the past years. Lectures will take place Thursday, Friday, & Saturday.

Please fill out a different survey for each course you are proposing. The deadline to submit is November 15, 2023

Question Title

* 1. Please enter your contact information

Name & Credentials *

Company *

Address

Address 2

City/Town

State/Province *

ZIP/Postal Code

Country

Email Address *

Phone Number *

Question Title

* 2. Company Affiliation

Hospital

Medical Center

University

Other (please specify)

Question Title

* 3. Course Title:

Question Title

* 4. Course Objectives:

Objective #1:

Objective #2:

Objective #3:

Question Title

* 5. Brief Course Description:

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* 6. Suggested length:

30 minutes

45 minutes

1 hour

Other (please specify)

Question Title

* 7. Suggested Format:

Lecture

Panel Discussion

Case Presentation(s)

Hands on lab

Other (please specify)

Question Title

* 8. Suggested Faculty (please put in order of preference and list contact information - phone and email is preferred)

Faculty #1

Faculty #2

Faculty #3

2024 Coastal Emergency Medicine Conference - Course Proposal Form

Question Title

* 1. Please enter your contact information

Question Title

* 2. Company Affiliation

Question Title

* 3. Course Title:

Question Title

* 4. Course Objectives:

Question Title

* 5. Brief Course Description:

Question Title

* 6. Suggested length:

Question Title

* 7. Suggested Format:

Question Title

* 8. Suggested Faculty (please put in order of preference and list contact information - phone and email is preferred)

Question Title

* 9. Questions? Please type your question below and our CEMC Program Chair, Dr. Cami Pfennig will get back to you.