Willingness to Participate Form 62nd Annual Spring Meeting - 2022April 28-30, 2022Virtual - On Demand • Carlsbad, CA WILLINGNESS TO PARTICIPATE FORM WP FORM FOR: Matthew Koepplinger, DO, FAOAOIf you are not Matthew Koepplinger, DO, FAOAO click here | Return to Faculty Forms. Contact Information Required fields are marked with an "*". Name: Matthew Koepplinger, DO, FAOAO Academic Title:* Academic Institution:* Academic Institution City/State: Preferred Mailing Address:* Phone Number: Fax Number: E-mail Address:* Admin Assistant Name: Admin Assistant Phone: Willingness To Participate/Adherence To Deadlines I have read the Willingness to Participate information below. These assignments have been made as a result of an invitation to perform the duties as a faculty member for the above-captioned meeting. Please indicate your participation in the following lectures, workshops, case discussions, and/or as moderator as outlined in the lecture schedule. Participation Date Lecture Title I will be lecturing: In-person Virtually I am pleased to participate in all lectures, workshops, case discussions, and/or as moderator as outlined in the lecture schedule. I will participate in this lecture I must decline this lectureFri, Apr 29, 2022 Hand with Question and Answer I agree to adhere to all deadlines outlined in my faculty letter/email.
