NEXGEN 2026 Application Form

Full Name

List your credentials (no acronyms, please spell out):

Title

Company Name:

Email Address:

Phone:

Links to Professional Profile (e.g., LinkedIn, Personal Website)

What is the level of your presentation?

For clinical presentations, please identify the percentage of your presentation (enter a number from 1-100%) that will be:

Scientific (%)

Case Studies (%)

100

Protocols (%)

100

Systemic Formulas strives to provide cutting-edge information to our conference attendees.

Please identify 3-5 new pieces of information, data, or concepts you will be presenting.

Presentation Title (as it will appear in the conference program)

Presentation Description (as it will appear in the conference program):

Learning Objectives:

Presentation Outline:

Have you presented this topic before?

A list of events where you have presented as a speaker in the past:

Links to a maximum of two of your best previous presentations or work examples (audio, video, or written):

Your professional bio or CV (or email separately [email protected]):

Click to choose a file or drag here

Size limit: 50MB per file

Additional notes or comments regarding your presentation:

Signature

Draw your signature above