Source: Society for Radiation Oncology Administrators website (www.SROA.org) Sep. 9, 2010
2010 Abstract Form
For submission of Workshop Presentation
Deadline: March 31, 2010
27th Annual SROA Meeting
San Diego, CA, Oct. 31-Nov. 3, 2010
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= REQUIRED
Title of Presentation:
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My Presentation best falls under the following track:
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Business / Leadership
Basic Management
Advanced Management
Both
Science / Technology / EMR
Coding and Reimbursement
Performance Measurement and Compliance/Quality
I am a
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SROA Member
Non Member
Financial Disclosure Statement
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Do you have or have you had in the previous 12 months a relationship with a company or organization whose products or services are directly related to the subject matter of your presentation?
Yes. Please indicate the nature of the relationship
No.
Please type the following information (the number in parentheses indicates the limit on the number of characters including spaces and punctuation):
Presenters
First Name:
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Middle Name:
Last Name:
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Generation:
(Jr., Sr., II, III)
Degree:
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(No Honors Or Certifications)
Department:
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Institution/Organization:
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Street Address 1:
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Street Address 2:
City:
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State/Province:
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Zip/Postal Code:
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Country:
Email:
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Telephone:
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Fax:
First Name:
Middle Name:
Last Name:
Generation:
(Jr., Sr., II, III)
Degree:
(No Honors Or Certifications)
Email:
Presentation Title:
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Describe in one clear sentence, the goal of the session and list up to three objectives.
Goal:
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Objectives:
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1.
2.
3.
Your abstract must be double-spaced and not exceed 150 words. Avoid excessive use of acronyms and abbreviations.
Please sure to complete the following. Please check all that apply
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My presentation is 45 minutes in length; I will allow 15 minutes for questions.
If accepted, I am willing to present my workshop twice during the SROA Annual Meeting.
I am willing to write an article on the same topic for the SROA newsletter
Radiation Oncology News
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If this work was not created by me, I have the proper copyright release information on file.
If accepted, I give permission to SROA to post my presentation in the Members Only section of the SROA website.
Remember:
1. Attach your abstract to this form.
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2. Remember to include your CV.
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3. Please include the other presenter's CV.
4. Remember to include a brief introduction (150 word limit)
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5. Please include a brief introduction for other presenter (150 word limit).