Abstract Submission FormSubmission Guidelines:

1. Please fill in the abstract submission form and return to conference secretariat at Conference Website (http://www.cuhk.edu.hk/scm/icbrcm) ONLY by deadline. Submission via other methods will NOT be accepted.

2. Author could submit more than one abstract, but the author has to use a NEW form for every abstract submission.

3. Submitted material is original work and has not been previously published.4. All abstracts must be submitted in ENGLISH and word limit is 500 words including acknowledgement.

No table and picture is allowed.5. Please make sure all information is properly filled in. No amendment is allowed after the abstract has

been submitted.6. Abstract submission form should be submitted in both Microsoft Word format (signature not

required) AND PDF format (signature required).7. Selected abstracts will be invited for poster presentation and published in the conference program

book.8. Once an abstract has been submitted, a confirmation e-mail will be sent to all authors within 2 working

days. Please notify conference secretariat via email (icbrcm@cuhk.edu.hk) in case confirmation e-mail is not received.

9. Notification of abstract acceptance/rejection will be made on or before 20 June 2018 (HKT) via email.10. Presenting author of accepted abstracts must register for the conference in order to present their

poster.11. Poster Presentation Competition:

The Conference Committee will select the best poster presented during the conference. The winners will be awarded a certificate.

12. For enquiry, please contact:Conference SecretariatSchool of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong KongTel: (852) 39439259 / (852) 39434329Email: icbrcm@cuhk.edu.hkConference Website: http://www.cuhk.edu.hk/scm/icbrcm

Official Use onlyAbstract no.: Date Received:Registration no.: ☐ Accept ☐ DeclineRemarks:

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Please fill in all the blanks and return the completed Abstract Submission Form to School of Chinese Medicine, CUHK via email (icbrcm@cuhk.edu.hk) by 15 June 2018 (HKT 23:59).

Presenting Author’s Information

Salutation ☐Prof ☐Dr ☐Mr ☐Mrs ☐Ms ☐Miss ☐Others: (Please specify)

Surname Given Name

Surname(Chinese, if available)

Given Name (Chinese, if available)

Position Gender

Institution /Organization

Department / Faculty

Mailing Address

Country Tel (Area code)-Tel no. Fax (Area code)-Fax no.

Email Address

Participate in Poster Presentation Competition? ☐ Yes ☐ No

Corresponding Author’s Information

☐ Same as above (Please leave this section blank if the information is the same as above)

Salutation ☐Prof ☐Dr ☐Mr ☐Mrs ☒Ms ☐Miss ☐Others: (Please specify)

Surname Given Name

Position Gender

Institution /Organization

Department / Faculty

Mailing Address

Country Tel (Area code)-Tel no. Fax (Area code)-Fax no.

Email Address

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Others co-author’s Information (Please extend the table if more than 4 co-authors)

Salutation ☐Prof ☐Dr ☐Mr ☐Mrs ☐Ms ☐Miss ☐Others: (Please specify)

Surname Given Name

Email Address

Salutation ☐Prof ☐Dr ☐Mr ☐Mrs ☐Ms ☐Miss ☐Others: (Please specify)

Surname Given Name

Email Address

Salutation ☐Prof ☐Dr ☐Mr ☐Mrs ☐Ms ☐Miss ☐Others: (Please specify)

Surname Given Name

Email Address

Salutation ☐Prof ☐Dr ☐Mr ☐Mrs ☐Ms ☐Miss ☐Others: (Please specify)

Surname Given Name

Email Address

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Abstract

Category (Please choose one)☐ Acupuncture for CNS disorders☐ Chinese medicines for CNS disorders

ABSTRACT TITLE (UPPERCASE)

Chinese Title of the Abstract (if applicable)

First Author1,Second Author2,Third Author3,Fourth Author4,Fifth Author5, Sixth Author6

Given name SURNAME (e.g. Peter SMITH)

Affiliation Details (Department, faculty, institution / organization, city, country)1Affiliation 12Affiliation 23Affiliation 34Affiliation 45Affiliation 56Affiliation 6

Content (Maximum 500 words including acknowledgement)Background and Aims:

Methods:

Results:

Conclusions:

Deadline for abstract submission: 15 June 2018 (HKT 23:59)

Declaration:I, the undersigned, represent and warrant that the submitted abstract (abstract title) is original work and the submission is in compliance with copyright laws.I am fully responsible for the information provided in this form. Consents have been obtained from all authors for the submission of the abstract and personal information.I give consent to the publication of the abstract in conference material.

__________________________________Corresponding author’s signatureTyped Name of Corresponding AuthorDate (DD/MM/YYYY)

DisclaimerThe personal data collected will be used by School of Chinese Medicine, The Chinese University of Hong Kong and the authorised personnel for processing captioned purposes only. All personal data you provided will not be disclosed to any third parties except as required by law or with your prior consent.

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