Research To Clinical Practice: Topic Submission Form

Topics will be received all year (rolling submission). A topic submission does not guarantee the topic will be chosen by the committee.

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* Contact Information

First & Last Name

Email Address

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* Proposed Topic

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* If you are a subject matter expert on this topic, could you be willing to collaborate with the Educational Resources Committee on content development?

Yes

No

I am not a Subject Matter Expert

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* Please list up to 5 subject matter experts on the topic, if known.