Pennsylvania Chapter Electronic Abstract Form

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

Submissions will be accepted ONLY from Associates of the Pennsylvania Southeast Region.

Abstract Title*

Please delete the sample abstract below and type or copy your abstract in its place. Limit your submission to 250 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.*

Submitted for*
First Author*
First Name*
Last Name*
ACP #*
(If you have applied for membership, have not yet received your ACP#, please enter 'pending'.)
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 Ashish Rana, MD, FACP at ashish.rana@crozer.org.

Page posted: April/10/2008

Contact Information

Eastern Region
Richard J. Simons, MD, FACP, Governor

Southeastern Region
Charles Cutler, MD, FACP, Governor

Western Region
Alejandro R. Gonzalez, MD, FACP

John Derrickson
Executive Director
Phone: 610-543-6880 or Toll-free: 800-846-7746
Fax: 610-543-6806
E-mail: pcim.hq@verizon.net