2022 CalDerm Fall Symposium - Poster Abstract Submission Form

To be considered for a Poster Presentation at the 2022 CalDerm Fall Symposium, please complete all requested fields below. Before you submit your abstract, be sure to review full eligibility requirements, rules, and submission guidelines here.

IMPORTANT DATES TO REMEMBER

Submission Deadline - Friday , July 22 at 11:59 PM (Pacific)
Acceptance Notification - TBD

Page 1 of 4

Presenting Author

Enter the contact information for the author who will present this abstract during the Poster Presentation, if selected. The Presenting Author will be required to complete a Conflict of Interest/Disclosures Form.

First Name *

Last (Family) Name *

Are you a current Resident or Medical Student? *

Resident

Medical Student

Credentials *

Residency Program Name *

Year of Residency Training (at time of presentation) *

Medical School Name *

Expected Date of Graduation *

Month

Day

Year

Email *

Cell Phone *

Is the presenting author a current CalDerm member? *

Yes

If selected, the listed Presenting Author (or suitable replacement) agrees to attend and present at the 2022 CalDerm Fall Symposium in Carlsbad, CA. *

I agree.

Is there an administrative contact for this submission, aside from the Presenting Author, with whom CalDerm should communicate? *

Yes

Administrative Contact

Enter information for administrative point of contact, if different from presenting author (above).

Full Name

Fall Symposium Emerald Sponsor