SIO Central : Case Spotlight Submission Request Form

Case Spotlight Submission Request Form

To submit a case for consideration for SIO Case Spotlight, please complete the following form. If your case is selected, you will be contacted via email with instructions to complete your submission.

*First Name

Middle Name

*Last Name

*Degree(s)

*Title

*Email

*Institution

*Diagnosis

*Subspecialty(ies) or disease

*Attending-level Physician Name (First and Last)

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

*Attending-level Physician Email Address

*List the three main teaching points of your case, should it be accepted.

*Provide the case discussion you will submit if your case is accepted:

*What makes this case great and/or different from a previously published case?

*Upload 1-2 images that corroborate your teaching points

Maximum File Size: 20000 KB