Submission Form

🔹 1. Personal Information
Full Name

Email Address

Phone (with country code)

Institution / Affiliation

Country

🔹 2. Type of Submission (Select one)
Scientific Oral CommunicationPoster PresentationWorkshop ProposalOther

🔹 3. Title of the Submission
Maximum 200 characters

🔹 4. Authors
First Author (Full Name)Co-Authors (Full Names)Presenting AuthoRFirst authorOther

🔹 5. Abstract (for Oral Communication or Poster)
Structure (max 300 words)
* Introduction / Background
* Objectives
* Methods
* Results
* Conclusion

You can also upload your abstract as a PDF or Word file

🔹 6. Workshop Proposal (if applicable)
* **Title of the Workshop**
* **Duration** (e.g., 60 min, 90 min)
* **Target Audience**
* **Max number of participants**
* **Description / Learning objectives**
* **Needs (equipment, room setup, support)**

Upload supporting material (slides, handouts, etc.)

🔹 7. Keywords (3 to 5)
(e.g., Regional anesthesia, POCUS, Pain management, Obstetric anesthesia, etc.)

🔹 8. Conflict of Interest Declaration

I declare no conflict of interestI have the following potential conflicts

🔹 9. Consent and Commitment

I confirm that this submission is original and not under review elsewhere.If accepted, I commit to presenting at the Congress.I authorize AFSRA to publish the abstract in the Congress program.

🔹 10. Additional Comments (optional)