Submitter Information
Date
MM
/
DD
/
YYYY
Name
Degree
Institution
Email Address
City/State/Country
ISHLT Membership Status
Member
Non-Member
Document Details
Document Type
Clear choice
Consensus Document
Guideline
White Paper
Standards Statement
Position Paper
Other
Formal Title of the Proposed ISHLT Document
Document Summary
(to include a description of the Professional Communities to which the document content will be relevant and how representatives of these PCs will be incorporated into the writing process)
Document Outline
(a table of contents to include the main content sections)
Document Overlap
(a list of published or under development documents by ISHLT or other Organizations with which the content of this document may overlap)
Proposed Project Leads
Is the submitter also a proposed Project Lead?
Yes
No
Project Lead 1
Name
Degree
Institution
Email address
City/State/Country
ISHLT Membership Status
Member
Non-Member
Project Lead 2
Name
Degree
Institution
Email address
City/State/Country
ISHLT Membership Status
Member
Non-Member
Do you have additional Project Leads?
Yes
No
Project Lead 3
Name
Degree
Institution
Email address
City/State/Country
ISHLT Membership Status
Member
Non-Member
If you have more than three Project Leads, please list the additional leads below:
(include name, degree, institution, email address, city, state, country)
Project Relevance
Primary Relevant Interdisciplinary Network
Advanced Heart Failure and Transplantation
Advanced Lung Failure and Transplantation
Mechanical Circulatory Support
Pulmonary Vascular Disease (PAH & CTEPH)
Other Interdisciplinary Networks to which the proposed document applies
Lung Failure and Transplantation
Mechanical Circulatory Support
Pulmonary Vascular Disease (PAH & CTEPH)
Other Interdisciplinary Networks to which the proposed document applies
Heart Failure and Transplantation
Mechanical Circulatory Support
Pulmonary Vascular Disease (PAH & CTEPH)
Other Interdisciplinary Networks to which the proposed document applies
Heart Failure and Transplantation
Lung Failure and Transplantation
Pulmonary Vascular Disease (PAH & CTEPH)
Other Interdisciplinary Networks to which the proposed document applies
Heart Failure and Transplantation
Lung Failure and Transplantation
Mechanical Circulatory Support
Professional Communities to which the proposed document applies
Anesthesiology & Critical Care
Cardiology
Cardiothoracic Surgery
Infectious Diseases
Nursing & Allied Health
Pathology
Pediatrics
Pharmacy
Pulmonology
Research & Immunology
Verification
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