1. Healthcare

2015 NJ State Stroke Conference Poster Submission
Please complete all the requested information below to submit your Poster Abstract to the New Jersey State Stroke
Conference. Please do not use all caps and enter the information as you would like to see it printed for the
conference, if your abstract is accepted.
Deadline: January 9, 2015
*1. Please include contact information for the corresponding author. All communication
will be sent to this author and it is the responsibility of this author to forward to co-authors.
First Name
Last Name
Credentials
Role/Position
Institutional Affiliation
Address Line 1
Address Line 2
City
State
Zip
Email
Telephone Number
*2. Stroke Systems of Care Model Priority Area (choose one):
j Primordial & Primary Prevention
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j Community Education
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j Notification & Response of EMS
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j Acute Stroke Treatment
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j Subacute & Secondary Prevention for Stroke
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j Rehabilitation
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j Continuous Quality Improvement (CQI) Initatives
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*3. Is this project IRB approved?
j Yes
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j No
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j N/A
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2015 NJ State Stroke Conference Poster Submission
*4. Does your abstract include data from the AHA/ASA Get With The Guidelines-Stroke
Patient Management Tool?
j Yes
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j No
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2015 NJ State Stroke Conference Poster Submission
Abstracts that include GWTG data require review and approval by the GWTG Science Subcommittee and Executive Database Steering Committee
prior to submission. Please see the full document located on the New Jersey State Stroke Conference Abstract Submission webpage for instructions
for submitting your data use request. If your abstract includes GWTG and was not approved by the GWTG Science Committee then your abstract
will be declined.
*5. Have you received approval for use of the GWTG-S Data in your presentation from the
GWTG Publications Committee?
j Yes
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j No
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j Requested and pending
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2015 NJ State Stroke Conference Poster Submission
*6. Project Title:
Please Note: This title will appear as written in marketing materials.
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*7. Please list authors and authors' affiliations as you would like them to appear in any
marketing materials.
Name, Credentials - Affiliation; Name, Credentials - Affiliation; etc. Example: Sandy Smith,
MD, FAHA - Anytown Hospital; John Smith, MPH - Northeast Department of Health
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*8. Project Narrative (3-5 brief sentences).
Please Note: Please write this as you would like it to appear in the marketing materials.
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2015 NJ State Stroke Conference Poster Submission
Please enter your abstract in the appropriate headings. It is recommended that you create your abstract in a word
document to ensure that your total word count for these sections is less than 2,750 characters and then paste the
information into this form.
*9. Purpose/Background
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*10. Objectives
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*11. Design/Methods
All statistical methods should be described, including statistical tests utilized to determine
the significance of the results.
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2015 NJ State Stroke Conference Poster Submission
*12. Results
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*13. Conclusions/Implications for Practice
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