Confirmation of Abstract PresentationIn order to confirm acceptance and secure your spot in the 2024 SIO Conference Program, please complete the necessary information below and submit by July 26, 2024. If you have any questions, please contact the Department of Continuing Medical Education at cme@coh.org. Please enter your contact information: First Name * Last Name * Email address * Do you accept the terms of your abstract submission or do you choose to withdraw? * Yes, I accept No, I would like to withdraw my abstract Please provide your abstract submission ID# and title: Submission ID #: * Title of your abstract: * Presenter Name as it should appear on conference materials: * RESTRICTIONS: • PLEASE PROVIDE A MAX OF 2 DEGREES • PLEASE DO NOT INCLUDE ANY FELLOWSHIP DESIGNATIONS (EX: FACS, FACP, ETC.) Presenter email: * Have you been accepted for a second abstract? * Yes No Please provide your abstract submission ID# and title of 2nd Abstract: Second Abstract Submission ID #: * Title of your second abstract: * Second Abstract Presenter Name as it should appear on conference materials: * RESTRICTIONS: • PLEASE PROVIDE A MAX OF 2 DEGREES • PLEASE DO NOT INCLUDE ANY FELLOWSHIP DESIGNATIONS (EX: FACS, FACP, ETC.) Second Abstract Presenter Email * Have you been accepted for a third abstract? * Yes No Please provide your abstract submission ID# and title of 3rd Abstract: Third Abstract Submission ID #: * Title of your third abstract: * Third Abstract Presenter Name as it should appear on conference materials: * RESTRICTIONS: • PLEASE PROVIDE A MAX OF 2 DEGREES • PLEASE DO NOT INCLUDE ANY FELLOWSHIP DESIGNATIONS (EX: FACS, FACP, ETC.) Third Abstract Presenter Email * Please confirm that presenter will register for the Conference prior to July 31, 2024. * FAILURE TO DO SO WILL RESULT IN YOUR ABSTRACT BEING REMOVED FROM THE PROGRAM. Yes No Please confirm that presenter(s) will register for the Conference prior to July 31, 2024. * FAILURE TO DO SO WILL RESULT IN YOUR ABSTRACT BEING REMOVED FROM THE PROGRAM. Yes No Please confirm that presenter(s) will register for the Conference prior to July 31, 2024. * FAILURE TO DO SO WILL RESULT IN YOUR ABSTRACT BEING REMOVED FROM THE PROGRAM. Yes No Leave this field blank
