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Abstract SubmittalSubmit your abstract for a podium, general poster, mentored student poster, or T35 poster using the above link. Abstracts are due no later than Midnight EST Monday, December 10, 2012. No exceptions. All persons making a podium or poster presentation must register for the meeting.Abstract Guidelines
Students applying for travel awards in the Mentored Student or T35 Student categories must submit additional materials as well. Full details are found in Awards in the Annual Meeting tab.If your abstract is accepted for presentation, download, print, complete, and submit this form.
American Auditory Society Disclosure/Conflict of Interest Statement
Program: American Auditory Society Scientific and Technology Meeting Date: March 7-9, 2013
Presenter’s Name: _____________________________________________________________________
Title of Presentation: __________________________________________________________________
DISCLOSURE POLICY: All faculty participating in an AAS sponsored activity are expected to disclose to the audience any significant financial interest or other relationship (1) with the manufacturer of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. Significant financial interest or other relationship includes such things as grants or research support, employee, consultant, stock holder of any amount, member of speakers’ bureau, etc. The intent of this disclosure is to enable the audience to determine whether the speaker’s interests or relationships may influence the presentation.
(1) PLEASE LIST ANY ITEMS FOR DISCLOSURE: Research Support/Grants Consulting/Employment Stock/Equity Speakers’ Bureau Other OR INITIAL THE FOLLOWING: _______ I have no significant financial relationship to disclose.
(2) PLEASE INDICATE ONE OF THE FOLLOWING BY INITIALING:
_____ I do intend and announce disclosure of unapproved/investigative use of a commercial product/device. _____ I do not intend to discuss unapproved/investigative use of a commercial product/device.
(3) PLEASE READ AND INITIAL THE FOLLOWING:
_____ I will comply with the Health Insurance Portability and Accountability Act (HIPAA) by insuring with the privacy of patients/research participants by refraining from using names, photographs or other identifying information in materials presented without the knowledge and written authorization of the patient/participant.
Date: Signature:
Please scan/email or mail this form to: American Auditory Society 7231 E Camino Valle Verde Tucson, AZ 85715
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