Surgical Research Symposium Form Surgical Research Symposium Registration Name(Required) First Last Credentials(Required)M.D., Ph.D., etc. Email(Required) Department(Required) College(Required) College of Medicine College of Pharmacy College of Nursing College of Public Health College of Health Professions Graduate School Other Enter Other College Name Location(Required) UAMS UA Fayetteville Other Enter Other Location Attending Only? Click if you are attending, but not presenting Title of Presentation(Required) Author Name(Required) First Last Co-Author Names Upload Abstract(Required)250 Words Max Author’s name must be included in the uploaded file name.Max. file size: 15 MB.Are you a Surgery Resident? Click if you are a surgery resident and would be interested in attending a Q&A and lunch with Dr. Schreiber. Do you have any special dietary restrictions or needs?Vegetarian, vegan, gluten free, etc. NameThis field is for validation purposes and should be left unchanged.