Poster Submission Instructions 
and Online Submission Forms

Please review the Criteria for Acceptance of Posters and the instructions below regarding preparation of Poster Session Abstracts before completing the online forms.

  1. All abstracts must be submitted electronically via the submission forms below. Submissions are not considered complete until all required forms from all authors have been received.
  2. Type the title of the abstract in CAPITAL LETTERS. The title should not exceed 10 words.
  3. Text within the Poster Abstract box must include the title as well as authors' and presenters' names as this is the text that is reproduced for publication. Do not exceed 300 words.
  4. Spell out complete names of all authors on the "AUTHORS:" line in the Poster Abstract box. Do not use initials alone. List city and state of origin. For abstracts submitted by multiple authors from one city, list the city and state once after all authors’ names have been listed. Maintain consistency in authors' names on multiple abstracts to avoid duplication in the author index.
  5. Indicate the name(s) of the presenter(s) on the "PRESENTED BY:" line in the Poster Abstract box.
  6. Type single-spaced within the abstract box. Double space only between paragraphs.
  7. The abstract should be informative and detailed. It must contain the following: an introduction and objective; methods; results obtained; and conclusion(s). It is not acceptable merely to state that the results will be discussed.
  8. Avoid excessive abbreviations in abstract. Abbreviations may be used only after the word has been written out once in full in the abstract.
  9. All abstract presentations and the question-and-answer period will be in English.

Part II: Presenter Information Form

1. Poster Title:

2. Presenter Information: All authors must complete and submit this form online.

Name

Degrees(s)

Title

Organization

Address

City/State/ZIP

Phone

No dashes please

FAX

No dashes please

E-mail

Are you the Primary Presenter? Yes    No

Are you an AMDA member? Yes    No

Are you a CMD? Yes    No

Is your poster a case study or research based?      Case Study       Research Based

Site of Service Please indicate which site of service along the LTC continuum that your presentation will address:

3. Abstract: You may cut and paste your abstract here.

4. Background Description (Must include information that is particularly relevant to the topic of your presentation)

Education/degrees/certification

Professional position(s) and accomplishments related to topic to be presented (e.g., special preparation, formal or informal job duties)

Presentation at professional conferences related to topic to be presented

Publications related to topic to be presented

My signature below indicates that I agree to abide by the decision of the Program Committee as final.

Signature (enter your initials)    Date (mm/dd/yy)

Part III: Faculty Disclosure 

Faculty Disclosure Declaration Policy
In order to ensure the continued success and reputation for integrity of our education programs, the Florida Medical Directors Association (FMDA) has adopted this full disclosure policy. 

It is not only proper, but likely, that faculty will have relationships with industry and corporations. This involvement in many instances brings recognition and prestige to the institution. Support from industry can contribute significantly to the quality of continuing medical education (CME) activities. There is nothing inherently improper in the involvement of commercial support for a CME activity. On occasion, situations may arise in which an individual faculty member has an outside interest that could be perceived as a conflict of interest. There is no attempt to preclude any faculty member from participating in any continuing medical education activity. It is our responsibility to disclose to the participants in that activity the nature of the faculty relationship so those listeners may form their own judgments about the presentation.

With the increased involvement of industry in continuing medical education, several organizations have issued statements and taken positions regarding the proper behavior of both individuals and organizations regarding involvement in commercially-supported CME. The American Medical Association has issued a statement regarding Gifts to Physicians from Industry; the Accreditation Council for Continuing Medical Education has issued Standards for Commercial Support of Continuing Medical Education; The Pharmaceutical Manufacturers Association has published the Code of Pharmaceutical Marketing Practices; and The Code of Interactions with Healthcare Professional; and the Association of American Medical Colleges has adopted Guidelines for Faculty Involvement in Commercially Supported Continuing Medical Education. The FMDA Board of Directors and Education Committee agree with the principles expressed in these documents.

Duty to Disclose

Each faculty member shall disclose any real or perceived relationships that are pertinent to the subject matter and could potentially be interpreted as biasing a presentation. In addition, faculty must disclose "off-label " uses of substances or products included in the presentation that are not approved in the United States and/or the status of substances or products that are being investigated for such use. 
Relationships that must be disclosed include, but are not limited to:

  • Service as a paid or non-paid consultant or employee; 
  • Significant personal holdings (by the faculty member and/or his/her immediate family) in any commercial entity that provides financial support for this CME activity, or products or services related to the subject matter of the CME activity; 
  • Receipt of financial support from a commercial firm or other source (consultant, research, educational grant, speakers bureau, honoraria, royalties, commissions, etc.); 
  • Research or institutional support. 

Faculty Disclosure Statement

ALL authors must complete and submit either Section A online, or if Section B is required, the entire Faculty Disclosure Statement form must be downloaded, completed and submitted, it its entirety. 

It is the policy of the Florida Medical Directors Association (FMDA) to ensure balance, independence, objectivity, and scientific rigor in all of its sponsored educational programs. All faculty members participating in these activities are required to disclose any significant financial interest or other relationship(s) that may have a direct bearing on the subject matter. This pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter. (Significant financial interest or other relationships can include such things as grants or research support, employee, consultant, major stockholder, member of speakers bureau, etc.) The intent of this policy is not to prevent a speaker with a significant financial or other relationship from participating. Rather, it is intended that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It remains for the audience to determine whether outside interests may reflect a possible bias in either the exposition or the conclusion(s) presented. Participant agrees to accept no payment for participation in this poster activity from any source.

This form must be completed and returned by each presenter/co-presenter.

Activity Title: FMDA’s 2014 ANNUAL Program

1. Poster Title:

2. Presenter Name 

Please complete and sign Sections A and C, or Sections B and C, below:

SECTION A

I have no financial conflict of interest or other relationship with a commercial entity in relation to this presentation. My presentation does not include discussion of "off-label" substance(s)/product(s) not approved in the United States for use under discussion or of substance(s)/product(s) that are being investigated for such use.

Signature (enter your initials)    Date (mm/dd/yy)

SECTION B: Financial and Scientific Disclosures

In order to maintain scientific balance and integrity in presentations, all disclosures will be included in on-site program materials.

If your response to this section is: Yes, I have a financial interest/arrangement/or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation. Please complete the AMDA/FMDA Faculty Disclosure Statement, which is available by clicking here and submit it separately.

SECTION C: Scientific Integrity and Commercial Support

By signature at the end of this disclosure declaration, I attest that I have carefully complied with ACCME Standards for Commercial Support and FMDA's policies regarding content and presentation of educational material, specifically, that my presentation will (please check each item delineated below to indicate your agreement):

be for scientific and educational purposes only and will not promote a company's products directly or indirectly;

reflect total control of content by me;

include no "scripting," emphasis, or influence on content by a company or its agents;

adhere strictly to principles of the highest quality, scientific integrity, and selection of content;

 

be free of commercial influence of bias in my comments, audiovisuals, and handout materials;

 

use generic names of pharmaceuticals or other medical products and provide balanced views of treatment options;

 

ensure that the content of slides, reference materials, and handouts in print, electronic, or other media will not enhance the specific proprietary interests of any commercial entity;

 

ensure delivery of my presentation free of the participation of industry representatives in the session room.

 

Signature (enter your initials)    Date (mm/dd/yy)

 

"Best Care Practices in the Geriatrics Continuum 2014"
is the annual conference which is joint-sponsored by the
Florida Medical Directors Association and
the American Medical Directors Association.