Literary AMWA Writing Submission
City, State, Zip Code
I am a(n)
Intern or Resident
Specialty (if applicable)
Affiliation (if any)
Title of Submission
Category of Submission
Writing must be original and unpublished, and patients must not be identifiable
I affirm that this is an original piece of writing that has not been published elsewhere. If this writing describes actual patients, all identifying characteristics have been removed.
Upload writing here (Microsoft Word format preferred)
Patient Consent (choose one of the following)
All patients described in the writing have signed release forms available at www.amwa-doc.org/literary-amwa. I have attached the form(s) below.
Some or none of the patients described in the writing have signed consent forms.
No actual patients are described in the writing.
Signed Patient 1 Consent Form (if applicable)
Signed Patient 2 Consent Form (if applicable)
Additional comments, if any
Should be Empty:
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