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COVER SHEET FOR ABSTRACT SUBMISSION
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| Name: | _______________________________________________________ | ||
| Institution: | _______________________________________________________ | ||
| Street Address: | _______________________________________________________ | ||
| City: | ______________________ | State: _______ | Zip: _____________ |
| Business Phone: | ___________________ | Fax: _____________ | |
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Type title of submission and name(s) of authors. Omit degree designations. Underline the name of the presenter. |
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| Title: | ______________________________________________________ |
| Author(s): | ______________________________________________________ |
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Check ONE of the following practice interest categories for this submission: |
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Primary Care/Managed Care | |
Nutrition Support |
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Clinical Services Management | |
Pharmacy Practice |
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Internal Medicine | |
Clinical Pharmacokinetics |
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Infectious Diseases | |
Pharmacoeconomics |
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Pediatrics/Neonatology | |
Hematology/Oncology |
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Critical Care | |
Psychopharmacy/Neurology |
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Cardiology | |
Geriatrics/Long-term Care |
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Drug Information | |
Medication Use Evaluation |
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Management | |
Community Practice |
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Other ___________________________ |
Mail Submission: (mail the following)
1. Print & complete the cover sheet for Abstract Submission
2. Abstract hard copy
3. Disk containing abstract labled with your name and word processing application
used.
4. Mail to:
The University of Texas
M.D. Anderson Cancer Center
Attn: Judy Chase, Midwest Pharmacy Residents Conference
Division of Pharmacy Box 90
1515 Holcombe Blvd.
Houston, TX 77030-4009
Email Submission:
1: Email abstract as attachment to mprc@mdanderson.org
2. Print complete and FAX (713-796-1910) or U.S. Mail cover sheet to address
above.