2025 SBMAA - Presenter Request Form

2025 SBMAA - Presenter Request Form

Presenter Request Form

2025 MEDS Conference, Los Angeles
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Job Title and affiliation*
Jamaat City*
YesNo
YesNo
YesNo
KahootQuizizzMentimeterOther
Please upload slide deck of previous talks (CME or otherwise)*

Cancelof
Credentials*
CV Upload (Optional)*

Cancelof
Presentation Title
Presentation Learning Objectives (3-5)
Brief Description of the session (100-150 words)*
PowerPointPanel DiscussionWorkshop
30 mins45 mins60 mins
Presentation Target Audience*
Which other health professionals can you possibly collaborate with?*
How is this presentation mumin centric (briefly explain)?*
YesNo
KahootQuizzezMentimeterOther
2019 - Chicago2022 - Chicago2023 - Dallas2024 - Los AngelesNone of the above
Any comments?
Final CME presentations will need to be submitted Sept 1, 2025
Should be Empty: