Create A Profile

Use the form below to create a profile that will be used for submission for any abstract on which you are an author. After creating this profile, you will receive an email with your username and password. Use these credentials to sign in and submit an abstract.

Indicating Your Primary Institution: Use the dropdown to find your primary institution by entering any part of the name or location. Do not paste the full institution name in the search field. If the institution does not appear in the list, select Other in the dropdown and add the institution’s name in the Other box. Select from the list whenever possible. Your Primary Institution is the entity that provides you with the largest portion of your income and benefits. Do not include Department, Division, or School names.

Please add CROIabstracts@iasusa.org and ai-support@communitybrands.com to your email account’s safe senders list so you do not miss important communications about CROI. Please check your spam/junk folders if you do not receive the email in your inbox.

* - indicates a required item.

Contact Information

* Prefix:

* First Name:

Middle Initial:

* Last Name:

Suffix:

APRN	DDS	DO
DSc	FNP	MBBS
MBChB	MD	MPH
MSN	MSW	NP
PA	PharmD	PhD
RN	RPH	Other
Other:

Degree Or License:

Professional Title:

* Primary Institution:

* Other:

Department, Division, or School:

* Address Line 1:

Address Line 2:

* City:

State, Territory, or Province (United States and Canada only):

Postal Code:

* Country or Territory:

Work Phone:

Mobile Phone:

* Professional Email:

* Confirm Professional Email:

Alternate Email:

Additional Information

The information below is collected for demographic purposes only, and is not used in making decisions about the disposition of abstract or scholarship submissions.

* Sex/Gender:

* Race:

This form collects name, email address and other contact information so we can contact you about the status of your submission and so our support team can communicate and provide essential assistance. Please check our Privacy Policy to see how we protect and manage submitted data. If you have created this form on behalf of someone else, checking below verifies that you have obtained the individual’s consent to having this contact information collected AND you have verified that all contact information (especially the email address) is correct.

*I consent to having this contact information collected via this form.