Abstract Proposal Form 2023 LGBT HWC Conference Abstract Submission First Name*Primary presenter Last Name*Primary Presenter Email*Primary Presenter Degree(s)*Primary Presenter Examples: B.A., M.P.H., M.D., P.A.-C. Please also include your field of study, if applicable (e.g., Ph.D. psychology). If you are currently enrolled in a degree-granting program, please indicate that here (e.g., high school student, B.S.N. student, M.D. student). Title(s)*Primary Presenter Affiliation*Primary Presenter Race / Ethnicity*Primary Presenter (check all that apply) Asian Black / African-American Native American / Alaskan native Hispanic / Latino White Other Specify if Other Gender Identity*Primary PresenterFemaleGender non-conformingMaleTransgender ManTransgender WomanOtherPrefer not to answerSpecify if Other Sexual Orientation*Primary PresenterBisexualGay / LesbianStraight / HeterosexualOtherPrefer not to answerSpecify if Other Telephone*Primary Presenter Address*Primary Presenter Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Additional Presenters/AuthorsPlease list co-presenters/authors, their degrees, their primary affiliation, race/ethnicity, sexual orientation, and gender identity in the following format: Jane Smith, R.N. (New York University School of Nursing) Latina lesbian woman No more than 2 co-presenters for oral presentations. There is no limit to the number of co-authors on poster presentations.Abstract Category*ResearchEducational InnovationBest PracticesTopic ReviewSubmission Type*Please indicate for which type of presentation(s) you would like your abstract considered.Panel PresentationPoster PresentationPanel and/or Poster PresentationsAbstract Title* Intended Audience*Select all that apply Pre-Health Professions Students Pre-Health Advisors Health Professions Students Faculty Educators Clinicians Activists Other Learning Objectives*Maximum 700 characters (approximately 100 words)Abstract Body*Maximum 2450 characters (approximately 350 words)CV uploadIf submitting for Panel Presentation, please upload CV for primary presenter and co-presenter. Files can be in MS Word format or PDF format. Drop files here or Select files Accepted file types: pdf, doc, docx, Max. file size: 32 MB, Max. files: 5. NameThis field is for validation purposes and should be left unchanged.