AADDS Winter Tri-Annual Meeting
Saturday, January 12, 2019
Piedmont Health

Viewing Protocol

Case Details
Physician(s) Presenting:*
Email Address(s):*
Office Phone:

Case Description (to be included with meeting syllabus)
Patient's Initials:*
Has Pathology been requested?
Date Requested:  
Lab #:
Noteworthy Features
Objective (physical findings, laboratory, etc.)
Histopathology (omit diagnosis, but give skin biopsy accession number and description of pathological findings)
Reason for Presentation (treatment, etc.)
References (format of Journal article Bibliography) - Please use name of Journal with volume and pages, not title of article.
Diagnosis (will be on a separate page)