Clone of A. NANT 16 CFA Abstract Submission

NANT 17 Conference Abstract Submission
Main Conference: April 9-10, 2027
Pre Conference: April 8, 2027
Location: Orlando, FL
- Are you submitting an abstract for:
- Abstracts will undergo a blinded abstract review process.
  
  A maximum of two Presenting Speakers/Authors may submit for oral presentations. Up to two speakers per oral presentation will receive complimentary Main Conference tuition. Speakers are responsible for their own travel and accommodation expenses. Co-Authors who are not presenting onsite may be listed later in this form.
  
  If you'd like your oral presentation to be considered for a poster, complete form separately as a poster submission.
- Presenter 1 Name
  
  First NameLast Name
- Presenter 1 Email Address:
  example@example.com
- Presenter 1 Title/Credentials
- Presenter 1 Cell Phone
  Format: (000) 000-0000.
- Presenter 1 Country
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Presenter 1 Introductory Bio (Limit 100 words)
  
  Bio will be read from the podium as your introduction at the conference. Bio will be verified at time of conference registration. 0/100
- Presenter 1 Photo
  
  Cancelof
- Presenter 1 CV Upload (2 page limit):
  
  Cancelof
- Additional Presenter?
- If applicable, please list any co-authors with credentials who are not presenting. Co-authors will be listed in the presentation description section of the agenda. You may also include them in your slide deck.
- Two poster presenters are allowed on the conference agenda.
  The poster may list all authors.
- Presenter 2
  
  The co-presenter you identify here will be notified that they need to complete a Financial Disclosure and Recording Consent form for this abstract. This is required for your abstract submission to be complete.
- Presenter 2 Name
  
  First NameLast Name
- Presenter 2 Title/Credentials:
- Presenter 2 Email Address:
  example@example.com
- Presenter 2 Cell Phone
  Format: (000) 000-0000.
- Presenter 2 Country
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Presenter 2 Introductory Bio (Limit 100 words)
  
  Bio will be read from the podium as your introduction at the conference. Bio will be verified at time of conference registration. 0/100
- Presenter 2 Photo
  
  Cancelof
- Presenter 2 CV Upload (2 page limit):
  
  Cancelof
- Please choose 1 of the following options for your submission:
- Abstract Submission for Oral Presentation
  
  Main Conference oral presentation submissions are typically accepted for 60 minute slots (45 min presentation and 15 min Q&A).
  
  Disclaimer – all submitted oral presentations may be considered for variations on the traditional one-hour talk, including shorter roundtables or shared sessions.
- Title of Oral Presentation. Limit 80 characters.
- Abstract: Tell us what your oral presentation is about. All acronyms must be spelled out at least once in the abstract submission. Limit 300 words.
  
  0/300
- Oral Presentation Type
- Research/CQI Type (select all that apply)
- If applicable, paste published study link in the box below.:
- Content Category: (Choose at least one)
- Please choose all the instructional methods you intend to use:
  
  Other
- Bibliography
  
  Per CE accreditors, provide at least 5 references from within the last 5 years to support your presentation. In addition, provide the level of evidence for the 5 most current resources. Use this Levels of Evidence chart as a reference for assigning the source levels.
- Bibliography:
- I have provided the level of evidence for the 5 most recent references cited in my bibliography.
- Objectives:
  
  List a maximum of 3 objectives for a one hour presentation. Objectives must be concise, measurable and realistic to time frame. Use correct format and language as outlined in the Helpful Tips for Writing Objectives.
  
  At the close of this presentation, participants will:
- Objective #1:
- Objective #2:
- Objective #3:
- Poster Presentation Abstract:
- Poster Content Category: (Enter at least one)
- Title of Poster Presentation. Limit 80 characters.
- Poster Abstract: Tell us what your poster presentation is about. All acronyms must be spelled out at least once in the abstract submission. Limit 300 words.
  
  0/300
- Poster Bibliography - Provide a bibliography with at least 5 references from within the last 5 years that support your presentation. 
  
  0/300
- Poster Objectives:
  
  List a maximum of 2 objectives. You may have more objectives on the poster. Objectives must be concise, measurable and realistic to the time frame. Click Here for Helpful Tips for Writing Objectives.
  
  At the close of this presentation, participants will:
- Poster Objective #1
- Poster Objective #2
- Poster presenters are responsible for all expenses.
- What is your role in this educational activity? Check all that apply
- HIPAA REQUIREMENTS
  
  To comply with the Health Insurance Portability and Accountability Act (HIPAA), we ask that all program planners and instructional personnel insure the privacy of their patients/clients by refraining from using names, photographs, or other patient/client identifiers in course materials without the patient's/client's knowledge and written authorization.
- I am in compliance with these HIPAA policies. (Initial Below):
- Conflict of Interest Disclosure
  
  Having an interest in an organization does not prevent a presenter from making a presentation, but the audience must be informed of this relationship prior to the start of the activity and any potential conflict must be resolved.
  
  All planners, faculty, and content specialists participating in this education activity must disclose to the audience any of the following:
  
  • Relationship with companies who manufacture products or provide services used in the treatment of the subjects under discussion in the educational activity.
  
  • Relationship between the planner, faculty or content specialist and commercial supporter(s) of the activity.
  
  • Intent to discuss unlabeled uses of a commercial product, or an investigational use of a product not yet approved for this purpose. All information disclosed must be shared with the audience either on the program handouts, advertising and/or audiovisual presentation.
  
  Section I: Financial Relationships - those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, gift, speaking fee, consulting fee, honoraria, ownership interest (e.g., stocks, stock options, or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial relationships can also include "contracted research" where the institution gets the grant and manages the funds and the individual is the principal or named investigator on the grant.
  
  Program Planners/Instructional personnel have a relevant financial relationship if that relationship could influence the information presented in the course and could be perceived as a conflict of interest by learners.
- Do you have relevant financial relationships to disclose?
- Select the type of relationship(s) that exist with companies/organizations who manufacture products used in the treatment or care of the subjects under discussion (Check all that apply)
- Please use this section to describe any of the relationships noted above. Include the name of the company and type of support:
- Will any of the relationships identified above cause the information about healthcare products and services in the educational content you control to be commercially biased?
- Section II: Nonfinancial relationships - relationships that might bias an individual including any personal, professional, political, institutional, religious or other relationship.
  
  Program Planners/Instructional personnel have a relevant non-financial relationship if that relationship could influence the information presented in the course and could be perceived as a conflict of interest by learners.
- Do you have relevant non-financial relationships to disclose?
- What is the nature of the non-financial relationship? Check all that apply.
- For what role? Check all that apply
- Please use this section to describe any of the relationships noted above. Include name of company and type of support.
- Will any of the relationships identified above cause the information about healthcare products and services in the educational content you control to be commercially biased?
- How will any conflict of interests be resolved?
- All financial and non-financial conflict of interest disclosures must be shared with theaudience prior to the presentation. How will conflict of interest be disclosed to theparticipants?
- Section III: Off-Label & Investigational Uses
- Will your presentation include any discussion of investigation or off-label uses of drugsand/or devices?
  
  Other
- Professional Behavior:
  
  As a presenter/instructor I will demonstrate high standards of professional conduct and do not discriminate against learners on the basis of gender, age, socioeconomic or ethnic background, sexual orientation, or disability.
  
  I am stating that the information recorded here is true to the best of my knowledge and reflective of my intentions. I agree that it is my professional responsibility to ensure an accurate report of my disclosures(s).
  
  I attest that the information in this disclosure is accurate at the time of completion and I agree to notify Tiphanie Nichols at the National Association of Neonatal Therapists (tiphanie@neonataltherapists.com) of any changes to this information between now and the presentation.
- RECORDING RELEASE AGREEMENT
  
  As part of our mission to provide education and mentoring to neonatal therapists, NANT will record all consented presentations via video/audio and capture associated visual materials for the benefit of neonatal therapists and NICU caregivers everywhere. With your consent, this content may be provided or sold as an online course in the future. Presentations are subject to a quality review process in order to be offered online. If NANT is then interested in offering your presentation as an online course, you will be contacted after the event, asked to complete a few additional tasks, and offered an honorarium for this purpose.
  
  I understand that this release applies only to the material delivered at the NANT Conference and does not prohibit me from using my own materials in any manner.
  
  Presenter decisions regarding consent to be videotaped are not available to the conference committee during abstract review. Therefore, your decision bears no weight in the review process.
- Recording Release Consent
  
  YES, I consent to the video/audio recording of the presentation(s) above including all associated visual materials to potentially be utilized for the purposes identified. (Consumers will not be able to electronically copy any PPT slides/photos as this is a video recording.) I understand that this release applies only to the material delivered at the NANT Conference and does not prohibit me from using my own materials in any manner.
- Abstract Submission Deadline: Monday, August 3, 2026
  Notification Date: Early October 2026
  
  NANT 17 is scheduled to be held in-person. However, in the unlikely event in-person restrictions occur, the event will be hosted online including all accepted sessions/posters.
  
  Thank you for your time and expertise!
- By signing my name here, I certify that the above disclosures and agreements are true to the best of my knowledge.
- Should be Empty:

RECORDING RELEASE AGREEMENT