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This form is to submit summary information for cases. The full writeup should be submitted as a Word file (in the Additional Information - Document field below).
What is the identifier on the slide?
If this is with a conference, what case number is it in the conference?
NOTE: Please keep the following fields BRIEF - they are meant as a SUMMARY (1-2 lines) of the important information. The full writeup will be linked as a document - these summaries are for ease of reference when looking at the slide on the website.
NOTE: In the diagnoses fields, please only submit DIAGNOSES, not descriptions! Descriptions should go in an attached Word document. These are intended as summaries only!
MUST be a number starting with F (i.e., F23852)