PACEP SA26 Spivey Abstract Submission
*Submission deadline is Monday, January 12, 2026. Be sure to refer to the formatting instructions for abstract submission found on the call for abstracts email. Please email emelnychuk@geisinger.edu with any questions.
Submission Date:
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Month
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Day
Year
Primary Presenter First Name:
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Primary Presenter Last Name:
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Primary Presenter Credentials:
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Primary Presenter Email
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example@example.com
Primary Presenter Cell Number
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Area Code
Phone Number
Primary Presenter Institution:
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Primary Presenter ACEP Number:
Primary Presenter Institution Type:
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Academic/Residency Program
Community Facility
Primary Presenter Institution City and State:
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City, State
Contact information if submission is being completed by someone other than primary presenter:
Name, Email, Phone Number
Please list ALL authors in order and complete ALL fields. Remember to appropriately place the presenting author in this list.
First Name
Last Name
Credentials
Level of Education/Training
Author:
Attending
Fellow
Resident
Medical Student
Undergraduate/Graduate Student
High School Student
Other
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Medical Student
Undergraduate/Graduate Student
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Medical Student
Undergraduate/Graduate Student
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Undergraduate/Graduate Student
High School Student
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Attending
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Medical Student
Undergraduate/Graduate Student
High School Student
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Attending
Fellow
Resident
Medical Student
Undergraduate/Graduate Student
High School Student
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Fellow
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Medical Student
Undergraduate/Graduate Student
High School Student
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Medical Student
Undergraduate/Graduate Student
High School Student
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Medical Student
Undergraduate/Graduate Student
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Medical Student
Undergraduate/Graduate Student
High School Student
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Attending
Fellow
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Medical Student
Undergraduate/Graduate Student
High School Student
Other
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Attending
Fellow
Resident
Medical Student
Undergraduate/Graduate Student
High School Student
Other
Author:
Attending
Fellow
Resident
Medical Student
Undergraduate/Graduate Student
High School Student
Other
Author:
Attending
Fellow
Resident
Medical Student
Undergraduate/Graduate Student
High School Student
Other
Abstract Title
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Primary mentor for this project:
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If no mentor, list the primary presenter
If accepted, would you like your abstract to be published in JACEP Open?
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Yes
No
Has this abstract already been published, or is planned to be published, in a journal or in the proceedings of a different scientific assembly?
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Yes
No
Do any authors listed on your abstract have disclosures? If so, please list author names and disclosures.
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Yes
No
Author name and disclosures (if applicable)
If your abstract is published in JACEP Open, would you consider submitting the related manuscript to JACEP Open first, before any other journals?
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Yes
No
Please upload abstract as a Word document file. Refer to the formatting instructions for abstract submission found on the call for abstracts email.
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Browse Files
Cancel
of
I certify that this research has been approved by and complies with my institution's review committee for human and animal experimentation, where appropriate.
Yes
No
I attest that the project was reviewed and approved by an IRB. IRB designation as exempt (i.e. HSRD) is acceptable.
Yes
No
I acknowledge that if accepted, the primary presenter will present in-person at PACEP SA26 at Kalahari and must register for the conference.
Yes
No
I acknowledge that if my submission is accepted to PACEP SA26, I give permission for its content to be shared in PACEP communications, including the PACEP Newsletter, website and social media.
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Yes, I agree
No, I do NOT agree
Signature
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Submit
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