Mission Statement: Advance Education, Research, and Quality of Care for the head and neck oncology patient.

American Head & Neck Society | AHNS

The mission of the AHNS is to advance Education, Research, and Quality of Care for the head and neck oncology patient.

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Program Committee Acceptance 2020

Step 1: Contact Information
Name*
First Last
Email*
Please confirm your email for future correspondence.
Assistant Email
Please provide/confirm your assistant email for future correspondence.
Phone
Please confirm your phone number.
Step 2: Are you willing to participate on the 2020 Program Committee?
Committee Acceptance:*
Participation includes reviewing abstracts for the meeting at the beginning of 2020. Please mark this time frame on your calendar.
- Yes, I am ABLE to review abstracts and participate.
- Regrets, I am not able to participate on the committee.
Will you attend and participate in the 10th International Conference on Head & Neck Cancer taking place July 18-22, 2020 in Chicago, Illinois?*
- Yes, I expect that I will be ABLE to attend the meeting.
- Regrets, I will not be able to attend the meeting.
Step 3: CME Disclosure
Disclosure of Financial Relationships*
A commercial interest is defined as an entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
- No. Neither I nor my spouse or partner have at present and/or have had within the last 12 months a financial relationship with a commercial interest.
- Yes. I and/or my spouse or partner have at present and/or have had within the last 12 months a financial relationship with a commercial interest.

Financial Relationship(s):

If you or your spouse/partner have at present and/or have had within the last 12 months a financial relationship with a commercial interest (A commercial interest is defined as an entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.), please list them below. To add additional lines, please click the + button to the right.

Commercial Interest/Company	For What Role?	What was Received?	Myself and/or Spouse/Partner

Step 4: Can you please tell us your areas of expertise for review purposes?
Please select your areas of expertise:*
- Cancer Biology
- Chemotherapy / Radiation / Adjuvant Treatment
- Education / Care Delivery
- Endocrine Surgery
- Functional Outcomes/Quality
- Health Services Research
- Hypopharynx/Larynx
- Imaging and Screening
- Nasopharynx/Paranasal Sinus/Skull Base
- Oral Cavity
- Oropharynx
- Reconstruction/Microvascular Surgery
- Salivary Gland
- Skin Cancers