Speaker Form

Deadline: November20, 2013

Please complete and submit this form to:
INDEX Conferences & Exhibitions Organisation Est.

P.O. Box: 13636, Dubai – United Arab Emirates

Tel: +971 4 3624717, Fax: +971 4 3624718

E-mail:

Presenter’s Name:
Title: / Prof. Dr. Others, please specify
Presentation Category: / General Anaesthesia
Regional Anaesthesia: Techniques, Rehabilitation & Outcome
Acute Pain
Chronic Pain
TCI - TIVA
Perioperative Pain Management
Perioperative Ventilation Modes
Massive Bleeding / Transfusion
Safety, Risk Management & Quality Assurance in Anaesthesia
Monitoring in Anaesthesia
Others, please specify______
Sector: / UAE GCC & MENA region International
Academic Private Others, please specify
Presenter’s
Profile:
(Maximum of 50 words)
Degree:
( e.g. :MD, PhD, MBBS & etc.)
Current Position:
Presentation Title:
Title should be in capitals (Maximum 20 words)
Abstract:(Maximum of 100 words)
Introduction:(Maximum of 50 words)
Materials & Methods: (Maximum of 50 words)
Results: (Maximum of 50 words)
Conclusion: (Maximum of 50 words)
Note:
Previously presented? / Yes or No
If yes, please specify in which conference?
Contact Information
Organisation:
Tel:
Mob:
Fax:
Email:
Address:
Please note that details provided above will be published in the Official Catalogue.

Abstract Submission Guidelines:

*(The term organiser means INDEX Conferences & Exhibitions Organisation Est.)

  • The submitted abstract should match the categories mentioned above.
  • Abstract should not exceed 100 words, single-line spacing. The abstract must be in English.
  • Abstracts should be submitted by e-mail to . Abstracts that are handwritten or sent by fax will not be accepted.
  • Abstract content must meet the standard of an academic / scientific presentation. The outline must have an Introduction, Objectives, Materials and Methods, Results and Conclusions.

I hereby accept and understand the guidelines for abstract submission and presentation.

1.I have made every effort to guarantee the accuracy of the information supplied herein in the Abstract Form.

2.I fully understand that Dubai Anaesthesia will not be held responsible for any errors or omissions in the information present in this form.

  1. I understand that I will be solely responsible for my presentation equipmentssuch as hard disk, flash memories, CDs, DVD and etc.And thatDubai Anaesthesia takes no responsibility, and disclaims any liability, for any equipment in regard to my presentation, which would be brought.

By signing this statement, I declare that the mentioned terms and conditions in points 1 to point 3 in the disclaimer statement and the guidelines and notes for abstract submission and presentation are understood and accepted, and will be complied with and maintained.

Signature: Date: