Letter of Intent for MDS Video Challenge
* = required field
NOTE: Cases that are to be presented at the MDS Video Challenge should not be presented as an abstract in the Poster Areas.
The author(s) of the Work hereby represents and confirms that he/she has obtained the written consent of any and all patient(s) featured or who are otherwise identifiable or used in the Work to such feature, identification or other use therein and that said consent fully complies with all applicable legal requirements relating to the use of said such patient identifiable material, including, without limitation, if applicable, the specific requirements of the United States Health Insurance Portability and Accountability Act of 1996 ("HIPAA").
By submitting this Letter of Intent, you agree to the above and your case(s) will be reviewed by a committee. By the end of May 2020, notifications will be sent out indicating the cases that will be formally considered for review and possible presentation.