The American Association of Endocrine Surgeons - Resources: Online Interesting Case Submission

AAES 2012 Annual Meeting

Online Interesting Case Submitter
Deadline: Friday, March 2, 2012 - 11:59pm CST

American Association of Endocrine Surgeons
33rd Annual Meeting

April 29-May 1, 2012
Iowa City, IA

Questions? Please contact AAES at 913.402.7102 or

* indicates required field

Principal Contact

This individual will receive all primary communication regarding the interesting case

Status If you are a Non-Member, please list a SPONSOR for your submission*	Member Non-member, AAES Sponsor:
*First Name
*Last Name
Credentials (ie: MD, PhD)*
*Institution
*Address (Line 1)
Address (Line 2)
*City
State/Province Outside of the US and Canada choose "International"*
*Zip Code
*Country
*Phone
Fax
*Email

Presenter

If selected, this individual will be the presenter for the interesting case and will receive all communication regarding presentation details.

Status	Member Non-member
*First Name
*Last Name
Credentials (ie: MD, PhD)
*Institution
Address (Line 1)
Address (Line 2)
*City
State/Province Outside of the US and Canada choose "International"*
*Zip Code
*Country
*Phone
Fax
*Email

* Case Presentation Title:

NOTE: PLEASE LIST TITLE IN ALL CAPITAL LETTERS.
(Sample Title: THIS IS THE TITLE OF OUR INTERESTING CASE)

Do not use abbreviations, or references to authors or institutions in the title. Please also DO NOT give away the answer to your case in the title. The title should invoke interest, but not give away the answer to the case.

All Authors:

List authors by First Name, Middle Initial, Last Name. Do not include medical degree or designation
For example: Michael J. Demeure

Institution

Name
City
State/Province Outside of the US and Canada choose "International"
Country

* Body of Interesting Case:

Number of words left: (Note: The form will not submit if you are over the word limit.)

Body of interesting case must be 250 words or less (not counting title or author string). No graphs or charts will be accepted within the body of the case. Do not use highlighting or italics for emphasis.

Speaker Disclosure:

* DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS Per ACCME regulations, the American College of Surgeons disclosure process must ensure that anyone who is in a position to control the content of the education activity has disclosed to us all relevant financial relationships with any commercial interest as it pertains to the content of the presentation. Should it be determined that a conflict of interest exists as a result of a financial relationship you may have, you will be contacted and methods to resolve the conflict will be discussed with you. In addition, all affirmative disclosures must be revealed by a slide at the beginning of the presentation. Failure or refusal to disclose or the inability to resolve the identified conflict will result in the withdrawal of the invitation to participate. I do not have any relevant financial relationships with any commercial interests AS IT PERTAINS TO THIS PRESENTATION I do have the following relevant financial relationships to disclose AS IT PERTAINS TO THIS PRESENTATION
List the names of proprietary entities producing health care goods or services, with the exemption of non-profit or government organizations and non-health care related companies with which you or your spouse/partner have, or have had, a relevant financial relationship within the past 12 months. For this purpose we consider the relevant financial relationships of your spouse or partner that you are aware of to be yours. Explain what you or your spouse/partner received (ex: salary, honorarium etc) and specify your role.
Commercial Interest
Nature of Relevant Financial Interest (include all that apply)
If your presentation describes the use of a device, product, or drug that is not FDA approved or the off-label use of an approved device, product, or drug or unapproved usage, it is your responsibility to disclose this information verbally to the learner during your presentation. CLICK HERE to review glossary of terms

Submit:

Your submission acknowledges these general understandings:

Certification Statement: I certify that the information contained in this case represents original work that has not been previously published and will not have been presented or be under consideration for presentation at a national or international meeting prior to the dates of this meeting.
If accepted for presentation, I agree to be present at the Annual Meeting to present my work.
Presenters/authors are responsible for all registration and travel expenses associated with attending the meeting.
You will receive an automatic email confirming your case submission. In order to ensure that all data has been received, you will also receive a FINAL CONFIRMATION EMAIL after the submitter closes. If you DO NOT receive this final confirmation, please contact AAES via email at or telephone at 913.402.7102.

* I have read the AAES Interesting Case Submission Guidelines, and I agree with these and all general understandings outlined above.

5019 W. 147th Street • Leawood, KS 66224 • 913-402-7102

ONLINE INTERESTING CASE SUBMISSION

Online Interesting Case Submitter Deadline: Friday, March 2, 2012 - 11:59pm CST

American Association of Endocrine Surgeons 33rd Annual Meeting