Session Proposal and Abstract Review RSVP Form
Name
*
First Name
Last Name
Degree(s)
Institution
*
Email
*
example@example.com
Would you like to participate as a reviewer for the 2021 Annual Meeting?
*
Yes
No
Please indicate the submissions you would like to review (select all that apply)
*
IARS Session Proposal Submissions
IARS, AUA and SOCCA Abstract Submissions
Please upload your CV:
Browse Files
Cancel
of
Please indicate if you are a member of IARS, AUA or SOCCA (select all that apply)
*
IARS
AUA
SOCCA
I am not a member of IARS, AUA or SOCCA
Please rank your subspecialty areas of expertise (up to 5).
Sub specialty Selection #1
*
Sub specialty Selection #2
Sub specialty Selection #3
Sub specialty Selection #4
Sub specialty Selection #5
CME Disclosure Form
*Do you or your spouse or your partner have, at present or within the past 12 months, financial relationships and/or affiliations with any commercial interest that provides products or services that are relevant to this CME activity? The Accreditation Council for Continuing Medical Education (ACCME) defines a commercial interest as any entity producing, marketing,re-selling or distributing health care goods or services consumed by, or used on, patients.
*
Yes
No
Type of Financial Relationship
*
By selecting I confirm, I authorize that the foregoing information is complete and truthful, and I agree to contact the Meetings and Education Department via email at meetings@iars.org to update this disclosure within 30 days if I acquire any new financial relationships.
*
I Confirm
I Decline
Submit
Should be Empty: