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Become a Sponsor or Exhibitor
EmpowerX Conference
A conference that is for us and by us
Speaker's Info
Name
Do you accept our invitation to speak at the EmpoweRx Conference
Yes
No
Do you agree to have name and image used in brochure, programs, and materials for the promotion of the 2023 EMPoweRx Conference
Yes
No
Professional Credentials
Email
Title of Presentation
Learning Objectives (if changing)
Bio
Up-to-date Curriculum Vitae
Photo
Select the statement that best describe any financial disclosures
No, I do not have (nor does any immediate family member have) a vested interest in or affiliation with any corporate organization offering financial support or grant monies for this continuing education activity, or any affiliation with an organization whose philosophy could potentially bias my presentation.
Yes, I have (or an immediate family member has) a vested interest in or affiliation with a corporate organization offering financial support or grant monies for this continuing education activity or with any organization that has a specific interest in the therapeutic areas under discussion, as follows:
If yes selected in the prior question, select the affiliation/ financial interest that is the most appropriate.
Grant/Research Support
Consultant
Stock Shareholder (directly purchased)
Speaker with honorarium
Other Financial or Material Support
Other Affiliation
If yes selected in the question 2, select the corporate organization of your affiliation/ financial interest below
Send
Important Information & Deadlines for the EmpoweRx Conference
02/13/23:
Speakers Info Due
Finalized Title (if changing) and learning objectives
Disclosures
Headshot
Bio
03/16/2023
2-3 Assessment Questions and answers that support learning objectives
04/17/23:
PowerPoint Presentation Due
05/15/23:
Last-minute changes to the presentation
Upload Assessment Questions
Upload Powerpoint Presentation
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Contact
#1107 78 Folly Road Ste B9 Charleston SC 29407
843-994-4429
Team@pharmacy-acutecareuniversity.com
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