SNACC

Welcome to the SNACC Online Abstract Submission Program
INSTRUCTIONS FOR PREPARING SNACC ANNUAL MEETING ABSTRACTS

-- ONLY ONLINE ABSTRACT SUBMISSIONS WILL BE ACCEPTED --

The following form must be filled out completely and accurately and submitted with each abstract, or the abstract will be rejected for technical reasons. All abstracts and Scientific Program Applications must be received by the Program Chair by June 1, 2008.

ONLY THOSE ABSTRACTS SUBMITTED IN ACCORDANCE WITH THESE INSTRUCTIONS WILL BE
ACCEPTED FOR GRADING.

Abstracts accepted for SNACC poster presentations will appear in the October issue of the Journal of Neurosurgical Anesthesiology (JNA), which will serve as the official program of the Annual Meeting.

*PLEASE FILL IN ALL FIELDS

Scientific Program Application - TOP

*Title of Abstract:

*Presenting Author (name, academic degree,):

*First Name	MI	*Last Name	Academic Degrees

*Presenting Author's Institution Name:

*Presenting Author's Mailing Address:

*City	*State/Country	*ZIP Code

*Work Phone:	Fax:

*Email: - (must be a valid email address, i.e. pparker@spidey.com)

Co-Authors (name, academic degrees,):

Co-Authors Institutions:

Co-Authors Address:

*	Is the presenting author a member of SNACC? Yes No

*	a.	Has this paper been presented previously? Yes No
	b.	If yes, where?

*Please choose the ONE category that best applies to your abstract.

	Cerebral Blood Flow/Physiology		Cerebral Blood Flow/Pharmacology
	Cerebral Ischemia/Molecular Biology		Cerebral Protection/Pharmacology
	Cerebral Protection/Techniques		Clinical Neurological Science/Pharmacology
	Drugs and Techniques		Monitoring/General
	Monitoring/Electrophysiology		Clinical Neurological Science/Critical Care
	Other

*Indicate the following.

Study involving patients or volunteers?

Yes No

Study involving animals?

Yes No

JNA Authorship Responsibility, Financial Disclosure and Copyright Transfer:
I have read an agree with the information contained in this document. JNA Copyright Transfer Form
Yes No

The Presenting Author is a Resident, Fellow, or Junior Faculty.

Yes No

Consider for the Integra Foundation Travel Award:
Yes No

Requirements: You must be a resident or fellow and plan to present the submitted scientific work on Oct 13th in Chicago, if it is accepted for poster presentation at the annual meeting (presenting author). You are required to register for the meeting.
Yes No

I am in the following year of training.
PGY 1 CA2 CA3 CA4 Fellow

*Electronic Signature: By typing your name you agree to have signed this document electronically.

Disclosure Statement - TOP

Having an interest in or affiliation with any corporate organization does not prevent a speaker from making a presentation, but the relationship must be made known to the audience in advance and any conflict of interest must be resolved to be in compliance with the Accreditation Council for Continuing Medical Education (ACCME).

In accordance with ACCME guidelines, we want to ensure a balance, independence, objectivity and scientific rigor at all accredited programs. We require that faculty/abstract presenter make full disclosure to the planning committee and the audience. Full disclosure entails indicating whether the faculty member/abstract presenter and or/his/her immediate family has any relevant financial relationships with any commercial interest to the provider. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. ACCME defines a “commercial interest” as any proprietary entity producing health care goods or services, with the exemption of non-profit or government organizations and non-health care related companies. All faculty/abstract presenters participating in this program agree to:

	A.	Disclose relationship with companies who manufacture products used in the treatment of the subjects under discussion.
	B.	Disclose relationship between the speaker and commercial support of the activity.
	C.	If refuse to disclose is checked this application will not be processed.
	D.	Use generic names of products, or several trade names.
	E.	Disclose any unlabeled uses of a commercial product, or an investigational use of a product not yet FDA approved.

All information disclosed will be printed in the program syllabus. You must complete the Disclosure Statement and submit it with your cover letter and abstract; failure to comply with the disclosure policy will preclude participation in the CME program.

Relationship with company(ies) who produce health care goods or services, with the exemption of non-profit or government organizations and non-health care related companies:

Yes No

(If yes, list company(ies) with the relationship below.)

Relationships with any of the commercial supporters of this CME activity:

Yes No

(If yes, list company(ies) with the relationship below.)

I refuse to disclose this information

Relationship	Corporate Organizations(s)
1. Salary
2. Ownership
3. Royalties
4. Stock Shareholder (Directly Purchased)
5. Equity Position
6. Funded Research
7. Consulting Fees
8. Honoraria
9. Other Material Support

	D.	Generic and Trade Names – Presentations must give a balanced view of therapeutic options. Presenters’ use of general names will contribute to this impartiality. If trade names are used, those of several companies should be used rather than only that of a single supporting company.
	E.	Unlabeled Uses of Products – When an unlabeled use of a commercial product, or an investigational use not yet approved for any purpose is discussed during an educational activity, the presenter is required to disclose that the product is not labeled for the use under discussion or that the product is still investigational.

My presentation will comply with Sections D-E above.

Yes No

	Electronic Signature: By typing your name you agree to have signed this document electronically.

N. B.: If any conflicts of interest exist they will be duly noted in the Supplement or Course Syllabus.

*Abstract Body (Blinded Version Only) - TOP

Abstract length is limited to 3300 characters. You currently have characters left

Most special characters display properly. If you need to use special characters and they do not translate properly, you can select the appropriate character from the list below, copy it, then paste it into the abstract body at the appropriate place.

Additional Files

You may submit up to three additional items such as charts, graphs, and tables. Only one item should be included per file. We will make every effort to submit to the judges and to print every file. These items will appear at the end of the abstract and will be scaled to fit into the allotted space.

The following file types are accepted: GIF, JPEG, TIFF, DOC, XLS and PDF
There is a 2M limit on file size. Submission will fail if this is exceeded.

Please Enter This Security Code:

SNACC
520 N. Northwest Highway
Park Ridge, IL 60068-2573
TEL: 847-825-5586 FAX: 847-825-5658
email: snacc@ASAhq.org