AAPM&R NGR Presentation Proposal

Thank you for your interest in presenting at AAPM&R’s National Grand Rounds! This opportunity is open to all members at every career stage. Please complete the form below to submit your presentation idea.

Session proposals will be reviewed and a member of the Education Team will follow up with additional details.

1. Full Name: *This question is required.

2. Email Address: *This question is required.

3. Phone Number: *This question is required.

4. AAPM&R Member ID (if known):

5. Years in practice:

6. Proposed Session Title:

7. Provide a brief description of your session proposal: *This question is required.

8. Why is this session needed? Details should include the knowledge or practice gap the session is intended to fill. *This question is required.

9. List 3-5 learning objectives that are clear, measurable, and achievable. Use actions words such as list, describe, define, demonstrate, conduct, etc.

Complete the sentence, "As a result of attending this session, participant will be able to..." *This question is required.

#1
#2
#3
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#5

10. Will additional speakers be joining you?

Space Cell	Name	Email Address
#1	#1: Name	#1: Email Address
#2	#2: Name	#2: Email Address
#3	#3: Name	#3: Email Address
#4	#4: Name	#4: Email Address