Texas Surgical Society
Call For Abstracts, Spring 2023 Meeting
Presenter Full Name
First Name
Last Name
City
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E-mail
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example@example.com
Office Contact Name
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First Name
Last Name
Phone Number
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Area Code
Phone Number
E-mail
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example@example.com
All Authors
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Title of Abstract
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Background
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Method
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Results
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Conclusion
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Chart/Table
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Literature References
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I DO/DO NOT have relevant financial relationships with commercial interests that pertain to the content of my presentation.
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Do
Do Not
Commercial Interest
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What I/Spouse/Partner Received
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My Role
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Honorarium
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I agree that I will not accept honorarium, travel expenses, in-kind contributions, or any other support from commercial companies in connection with this activity.
Certify Disclosure
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By checking this box I certify that I have identified and disclosed all relevant financial relationships with any commercial interests and that all information provided herein is true and correct.
Final Agreement
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I agree with these general understandings.
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