PACEP SA24 Call for Images

PACEP SA24 Call for Images

*Please email Alexandra.Amaducci@lvhn.org with any questions.
Submission Date:*

MonthDayYear
Presenter First Name:*
Presenter Last Name:*
Presenter Email*
example@example.com
Presenter Cell Number*

Area CodePhone Number
Presenter Credentials:*
Presenter Institution:*
Contact information if submission is being completed by someone other than primary presenter.
Name, Email, Phone Number
Image Title*
Question related to image (i.e., What is common presenting symptom of this pathology?)*
Answer to question*
Please upload Image a PDF file only:*

Browse Files
PDF should only include the image and not the question. You may be contacted for a JPEG version of this file. Cancelof
I certify that this image is HIPAA compliant.

Disclaimer Notice: You do not need to be present at the conference to present your Image, but you should be registered for the conference if this image is chose to be displayed.
Signature*
Should be Empty: