2015 Abstract Submission Guidelines
The abstract submission must include the following information (unless indicated as optional).
Title of Abstract
Author and School/Institution:
If more than one author, indicate presenting author here. Other authors may be indicated below.
Contact information of Presenting Author:
Address:
Address 2:
City, State, ZIP:
Phone:
E-mail*:
*all correspondence about the poster session will go to this e-mail address.
Contact information for other Authors: (if applicable)
Address:
Address 2:
City, State, ZIP:
Phone:
E-mail:
Address:
Address 2:
City, State, ZIP:
Phone:
E-mail:
Two Keywords for Abstract
1.
2.
Student Involvement:
The student must have participated sufficiently in the work to take responsibility for the content
of the abstract and be willing to provide any relevant data upon request. The submitter must
certify that the student has contributed substantially to: (1) the conception and design or
analysis and interpretation of data and (2) the drafting and final approval of the submitted
abstract. The exact contributions of the student must be specified.
Audience Educational Objectives for abstracts in 50 words or less:
Provide at least one (1) measurable and concrete learning objective for your audience. Start
each sentence with one of these objective verbs: Define, List, Describe, Discuss, Explain,
Identify, Demonstrate, Differentiate, Compare, Design, Formulate, Evaluate, Assess, Name, and
Analyze. (It is recommended that students view a podcast on "The Art of Crafting Learning
Objectives" http://www.deltaomega.org/keyResources.cfm )
Target Audience (Optional)
Abstract Content (may not exceed 250 words)
Conflict of Interest Disclosure
A Conflict of Interest (COI) is present if any relationship of a financial, professional, or personal
nature exists that would potentially bias the presenter, speaker, discussant, respondent, faculty
because it may have an impact on the content of an educational activity.
Such a relationship may be:


with a commercial entity, or entity controlled/owned by an entity that produces, markets,
re-sells, or distributes healthcare goods or services that are consumed by, or used on,
patients/clients. Pharmaceutical or biomedical device entities whose goods or services
are related to therapeutic areas are such commercial entities.
A salary; consulting fee; honoraria; ownership interest except diversified mutual funds;
private research or program contracts or grants; publications; royalties; membership on
advisory or top level boards or panels that give remuneration.
Exempt entities that are not considered commercial entities for CE purposes are non-profits,
governments, and non-healthcare related companies.
Required Disclosure:
During the past 12 months have you, or your spouse or partner had a financial, professional or
personal relationship that might potentially bias and/or impact content of the educational
activity/session?
Yes
No
You must disclose the names of the organizations with which you have this relationship, the
nature of your relationship, and the clinical or research area involved if you answered “Yes”
above.
APHA Presenter Requirements:
In accordance with, I understand that in order to present at the poster session, I must become
an individual member of APHA and register for the APHA annual meeting. I do not need to
register or become a member unless I am selected and agree to present at the Delta Omega
poster session.
Yes
No