PCN Research and QI Virtual Symposium
Please complete the form below, providing all the necessary details regarding your research/QI project and poster. All submissions are due by 11:59 pm on Aug 1st. Accepted Posters will be notified by the end of August. 
Sign in to Google to save your progress. Learn more
Email *
Name of  Primary Presenter
Hospital or Institution of Presenter
Are there additional presenters for this presentation? If so, please provide their names and institutions here.
Please provide tentative topic for your poster.
Please provide 3 objectives/learning goals that summarize your proposed poster?
Please provide abstract for the poster you wish to present (250 words or less)
Please provide a bibliography of key references used for the poster presentation? 
Has this research or QI project been previously published or submitted for publication?
Clear selection
Please list any funders or sponsors who are connected to this research or QI project.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Virginia Commonwealth University. Report Abuse