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Dr. George Perez Research Colloquium Abstract...Form Name: Dr. George Perez Research Colloquium...

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Form Name: Dr. George Perez Research Colloquium Abstract Submission Time: November 17, 2016 3:17 pm Browser: Firefox 47.0 / Windows 8.1 IP Address: 149.150.236.168 Unique ID: 287249143 Location: 40.749000549316, -74.261299133301 School of Health and Medical Sciences and the Seton Hall-Hackensack Meridian School of Medicine 28th Annual Dr. George Perez Research Colloquium Abstract Submission Form Title of Abstract Title of Abstract Author Information Primary Author Last Name (Surname) Smith Initials for First & Middle Names of Primary Author (e.g. "J.D." for "James" as first name, and "David" as middle name) J.D. Affiliation of Primary Author 1. Seton Hall University - Health Sciences Graduate Programs (M.S. Athletic Training, M.S. Occupational Therapy, M.S. Physician Assistant, M.S. Speech-Language Pathology, Doctor of Physical Therapy, Master of Healthcare Administration, PhD in Health Sciences) Position/Title of Primary Author Student Is there an additional author? Yes Author 2 Last Name (Surname) Riley Initials for First & Middle Names (e.g. "J.D." for "James" as first name, and "David" as middle name) S.P. Affiliation 1. Seton Hall University - Health Sciences Graduate Programs (M.S. Athletic Training, M.S. Occupational Therapy, M.S. Physician Assistant, M.S. Speech-Language Pathology, Doctor of Physical Therapy, Master of Healthcare Administration, PhD in Health Sciences) Position/Title Faculty Is there an additional author? No Author 3 Author 4 1
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Page 1: Dr. George Perez Research Colloquium Abstract...Form Name: Dr. George Perez Research Colloquium Abstract Submission Time: November 17, 2016 3:17 pm Browser: Firefox 47.0 / Windows

Form Name: Dr. George Perez Research Colloquium AbstractSubmission Time: November 17, 2016 3:17 pmBrowser: Firefox 47.0 / Windows 8.1IP Address: 149.150.236.168Unique ID: 287249143Location: 40.749000549316, -74.261299133301

School of Health and Medical Sciences and the Seton Hall-Hackensack Meridian School of

Medicine

28th Annual Dr. George Perez Research Colloquium Abstract Submission FormTitle of Abstract Title of Abstract

Author InformationPrimary Author Last Name (Surname) SmithInitials for First & Middle Names ofPrimary Author (e.g. "J.D." for "James"as first name, and "David" as middlename)

J.D.

Affiliation of Primary Author 1. Seton Hall University - Health Sciences Graduate Programs (M.S.Athletic Training, M.S. Occupational Therapy, M.S. PhysicianAssistant, M.S. Speech-Language Pathology, Doctor of PhysicalTherapy, Master of Healthcare Administration, PhD in HealthSciences)

Position/Title of Primary Author StudentIs there an additional author? Yes

Author 2Last Name (Surname) RileyInitials for First & Middle Names (e.g."J.D." for "James" as first name, and"David" as middle name)

S.P.

Affiliation 1. Seton Hall University - Health Sciences Graduate Programs (M.S.Athletic Training, M.S. Occupational Therapy, M.S. PhysicianAssistant, M.S. Speech-Language Pathology, Doctor of PhysicalTherapy, Master of Healthcare Administration, PhD in HealthSciences)

Position/Title FacultyIs there an additional author? No

Author 3

Author 4

1

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SAMPLE SUBMISSION Pages 1-4 / BMS, CI, HSR, IP categories Pages 5-8 / CV category
Page 2: Dr. George Perez Research Colloquium Abstract...Form Name: Dr. George Perez Research Colloquium Abstract Submission Time: November 17, 2016 3:17 pm Browser: Firefox 47.0 / Windows

Author 5

Author 6

Author 7

Author 8

Abstract ContentAbstract Introduction Abstract Introduction - 800 characters maximum. Sample text

sample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample text.

Abstract Category Basic Medical Sciences (BMS)

BMS, CI, HSR, IP: Methods, Results & ConclusionAbstract Methods Abstract Methods - 800 characters maximum. Sample text sample

text sample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sampl

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Page 3: Dr. George Perez Research Colloquium Abstract...Form Name: Dr. George Perez Research Colloquium Abstract Submission Time: November 17, 2016 3:17 pm Browser: Firefox 47.0 / Windows

Abstract Results Abstract Results - 1200 characters maximum. Sample text sampletext sample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample te

Abstract Conclusion Abstract Conclusion - 800 characters maximum. Sample text sampletext sample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sa

CV: Case Report, Discussion

ConfirmationIs there a potential conflict of interest? YesPlease describe the conflict of interest: If a conflict exists, describe it here.Was the study approved by an IRB?(Note: Clinical Vignettes do not requireIRB approval. All other studies requireIRB approval or they will not beconsidered for the Colloquium.)

Yes

If yes, please indicate the IRB here: Enter the IRB here.If my abstract is accepted, I agree topresent it at the colloquium via posteror orally.

Yes

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Page 4: Dr. George Perez Research Colloquium Abstract...Form Name: Dr. George Perez Research Colloquium Abstract Submission Time: November 17, 2016 3:17 pm Browser: Firefox 47.0 / Windows

Re-enter Primary Author's Full Name(cannot be a Faculty Member)

Joseph Smith

Primary Author Email Address [email protected]: Email Address(es) ofadditional Individuals - 1

[email protected]

Campaign Source (direct)Campaign Medium (none)Campaign Name (direct)

4

Page 5: Dr. George Perez Research Colloquium Abstract...Form Name: Dr. George Perez Research Colloquium Abstract Submission Time: November 17, 2016 3:17 pm Browser: Firefox 47.0 / Windows

Form Name: Dr. George Perez Research Colloquium AbstractSubmission Time: November 17, 2016 3:23 pmBrowser: Firefox 47.0 / Windows 8.1IP Address: 149.150.236.168Unique ID: 287250378Location: 40.749000549316, -74.261299133301

School of Health and Medical Sciences and the Seton Hall-Hackensack Meridian School of

Medicine

28th Annual Dr. George Perez Research Colloquium Abstract Submission FormTitle of Abstract Title of Abstract

Author InformationPrimary Author Last Name (Surname) SmithInitials for First & Middle Names ofPrimary Author (e.g. "J.D." for "James"as first name, and "David" as middlename)

J.D.

Affiliation of Primary Author 5. Trinitas Regional Medical CenterPosition/Title of Primary Author Resident/FellowIs there an additional author? Yes

Author 2Last Name (Surname) RileyInitials for First & Middle Names (e.g."J.D." for "James" as first name, and"David" as middle name)

S.P.

Affiliation 5. Trinitas Regional Medical CenterPosition/Title FacultyIs there an additional author? No

Author 3

Author 4

Author 5

Author 6

Author 7

5

rileylor
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SAMPLE SUBMISSION Pages 1-4 / BMS, CI, HSR, IP categories Pages 5-8 / CV category
Page 6: Dr. George Perez Research Colloquium Abstract...Form Name: Dr. George Perez Research Colloquium Abstract Submission Time: November 17, 2016 3:17 pm Browser: Firefox 47.0 / Windows

Author 8

Abstract ContentAbstract Introduction Abstract Introduction - 800 characters maximum. Sample text

sample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample text.

Abstract Category Clinical Vignette (CV)

BMS, CI, HSR, IP: Methods, Results & Conclusion

CV: Case Report, Discussion

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Page 7: Dr. George Perez Research Colloquium Abstract...Form Name: Dr. George Perez Research Colloquium Abstract Submission Time: November 17, 2016 3:17 pm Browser: Firefox 47.0 / Windows

Abstract Case Report Abstract Case Report - 2400 characters maximum. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample textsample text. Sample text sample text sample text. Sample textsample text sample text. Sample text sample text sample text.Sample text sample text sample text. Sample text sample te

Abstract Discussion Abstract Discussion - 500 words maximum. Sample text sample textsample text sample text. Sample text sample text sample textsample text. Sample text sample text sample text sample text.Sample text sample text sample text sample text. Sample textsample text sample text sample text. Sample text sample textsample text sample text. Sample text sample text sample textsample text. Sample text sample text sample text sample text.Sample text sample text sample text sample text. Sample textsample

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Page 8: Dr. George Perez Research Colloquium Abstract...Form Name: Dr. George Perez Research Colloquium Abstract Submission Time: November 17, 2016 3:17 pm Browser: Firefox 47.0 / Windows

ConfirmationIs there a potential conflict of interest? YesPlease describe the conflict of interest: If there is a conflict, describe it here.Was the study approved by an IRB?(Note: Clinical Vignettes do not requireIRB approval. All other studies requireIRB approval or they will not beconsidered for the Colloquium.)

Yes

If yes, please indicate the IRB here: Enter the name of the IRB here.If my abstract is accepted, I agree topresent it at the colloquium via posteror orally.

Yes

Re-enter Primary Author's Full Name(cannot be a Faculty Member)

Joseph Smith

Primary Author Email Address [email protected]: Email Address(es) ofadditional Individuals - 1

[email protected]

Campaign Source (direct)Campaign Medium (none)Campaign Name (direct)

8


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