Indiana Chapter Electronic Abstract Form

Deadline - September 30, 2008
WARNING: This form is programmed to reject all submission attempts after Midnight, September 30, 2008

Abstract Title*

Please delete the sample abstract below and type or copy your abstract in its place. Limit your submission to 450 words or less. Type single-spaced. For electronic submission, you do not need to stay within the borders. The abstract form does not accept graphs, charts, tables, etc. PLEASE NOTE: Copying and pasting your e-mail content from Microsoft Word may cause formatting problems. We recommend that you copy your abstract from a text file.*

Submitted for*
First Author*
First Name*
Last Name*
ACP #*
(If you have applied for membership, have not yet received your ACP#, please enter 'pending'.)
Residency Program or Medical School*
Year: (PGY-1, 2, or 3; MS 1 - IV)*
Address 1*
Address 2
City*
State*
Zip*
Home Phone*
E-mail*
Additional Authors (please list, if any)
Program Director's First Name*
Program Director's Last Name*
Program Director's Email*
Program Director's Phone*


If you have questions about the Abstract Competition, please contact Tifinni Romero, the Associates Council Chair at tromero@chsmail.org.

Page Updated September 29, 2008

What's New

Contact Information

Indiana Chapter Governor:
Michael C. Sha, MD, FACP

Shelly Symmes
Chapter Administrator
Ph: 317-261-2060
Email: ssymmes@ismanet.org