Case Suggestion Form
Welcome,

Case Suggestion Form

The first step to submitting a case is to fill out the following case suggestion form. Once the editors have reviewed your suggestion, they will let you know their decision via e-mail. Please be as specific as possible when submitting your suggestion. Provide as much information as possible to facilitate the review process. If you do not provide sufficient information, you will be asked for additional information before your suggestion can be approved. If your suggestion is accepted, you will receive an e-mail containing detailed instructions on how to submit your case.

Please fill out the following form to submit your suggestion.
All the required fields (*) must be filled in before clicking the Submit button.

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* An attending-level physician must be named in all cases. Please provide their information:

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  • You must enter your first name
  • Please enter a valid first name
  • please enter a valid middle name
  • You must enter your last name
  • please enter a valid last name
  • You must enter your degree(s)
  • You must enter a title
  • You must enter your email address
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  • You must enter your institution name
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  • Your must enter diagnosis information
  • You must check off the Certify
  • You must select atleast one Subspecialty
  • You must select atleast one Modality
  • You must enter Attending-level physician name
  • You must enter Attending-level physician email address
  • Enter a valid Attending-level physician email address!
  • You must enter three main teaching points
  • You must enter Case discussion
  • You must enter differences from previously published cases
  • You must upload minimum one file
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