AIM-RADIAL 2019 Clinical Case Form
AimRADIAL Conferences 2019, Chicago, IL, USA
1. Corresponding Author
First Name *
Your answer
Family Name *
Your answer
Degree / title
Your answer
Institution / Hospital / Company / Office Address *
Your answer
City *
Your answer
State
Your answer
Country *
Your answer
Email *
Corresponding author will be notified of acceptance of the clinical case by email
Your answer
Corresponding Author and Presenting Author *
Answer 'YES' if SAME name. IF NOT THEN specify first name and family name of presenting author
Your answer
2. Clinical Case
Clinical Case Title *
Title should be brief
Your answer
Operator(s) *
Type family name followed by initials of the first name of the authors (ex. Mozart W.A., Gershwin G. etc.)
Your answer
Disclosure Statement Related to Content of Case *
I or members of my family have a financial arrangement DIRECTLY RELATED to the CONTENT of this clinical case or its supporter(s)
Required
3. Clinical Case Submission
Your clinical case will be evaluated as a PowerPoint presentation (10 slides maximum). The following should be included on the slides:

- Clinical history: preferably 4-5 sentences

- Challenge: summary of the challenging situation, 1-2 sentences

- Procedure: summary of each slide presented in sufficient detail to support conclusions

- Conclusion: statement of the conclusions reached. It is not satisfactory to state "The results will be discussed" or "Other data will be presented"

- Comment: 2 sentences

Send your PowerPoint presentation via email at: aimradial@criucpq.ulaval.ca
Looking forward to meeting you in Chicago
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