Pennsylvania Chapter Western Region Electronic Abstract Form

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

Please use this form for submitting Case Report abstracts only. Submissions will be accepted only from Associate members of the Pennsylvania Western 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 Andrew Adams, MD, at aadams1@wpahs.org.

Page posted: July/10/2008

What's New

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