REGISTRATION

REGISTRATION IS NOW FULL. WE WILL ACCEPT NEW REGISTRATIONS UNDER A WAITING LIST. Due to the Steering Committee's interest in ensuring that abstracts of important work will be included at this meeting, waiting list priority will be given to those registrants who submit abstracts for presentation. WE WILL NOTIFY ACCEPTED CANDIDATES BY EMAIL ON A ROLLING BASIS BY MARCH 29 AT THE LATEST. Please email Teresa Valero (TValero@novaresearch.com) with any questions.

NCI and ASCO are seeking participation of key leaders/representatives from sites/organizations who are actively engaged in clinical trial recruitment and conducting research and interventions to enhance accrual.

* An asterisk indicates the field is required for your form to be properly submitted. Thanks!

*Salutation: Other : (Please Specify)

* First Name:

* Last Name:

* Academic Degree(s): Other : (Please Specify)

* Title:

Division:

* Affiliation:

* Address 1:

Address 2:

* City:

* State/Province:

* ZIP/Postal Code:

* Country:

Other Country:

For Telephone and Fax: Use dashes only — no parentheses

* Telephone:

Fax:

* E-mail:

* Confirm E-mail:

Your responses to the following questions will help ensure a balanced mix among Symposium breakout sessions. Please answer based on your primary role and focus at this Symposium.

* Current position (select one)

* Current focus of clinical trial accrual efforts (select one)

Academic Medical Center
Community Cancer Center
Private Practice
Other : (Please Specify)

* Type of trials you are primarily involved in (select one)

Prevention
Early Detection/Screening
Treatment (early and late phase)
Symptom Management/Survivorship/Palliative Care
Imaging and Biomarker Studies
Other : (Please Specify)

* Symposium Breakout Sessions. Please rank your top 4 choices from the following 7 sessions—1 for most interested, to 4. We will try to assign you to the sessions of your choice.

Track 1: Patient/Participant-Centered Solutions (Interventions targeted at helping patients and communities better understand and access trials)

The Science of Patient Participation, Decision-Making and Informed Consent

The Science of Minority and Underrepresented Population Accrual

The Science of Community Outreach, Education, and Participation

Track 2: Physician and Provider-Centered Solutions (Interventions targeted at improving physician/provider communication and planning for clinical trials).

The Science of Physician/Provider Communication with Participants and Colleagues

The Science of Recruitment Planning and Evaluation

Track 3: Site Leadership, Infrastructure and Operations (Strategies optimizing site leadership and operations to better select and support trials to reach accrual goals)

The Science of Effective Leadership and Organizational Culture to promote accrual

The Science of Trial Selection, Infrastructure, and Operations

The Symposium will include an opportunity to present your completed and/or emerging research underway on clinical trial accrual as part of an interactive poster session and plenary presentations. Abstract submissions will be accepted from mid-December through early-February. Please indicate whether you are considering submission of an abstract:

Yes No