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  pdftitle    = {Karl-Heinz-Hoehne-Preis},
  pdfsubject  = {Questionnaire 2023},
  pdfauthor   = {Dagobert Duck},
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\lhead{{\huge medvis-award}\\\large Karl-Heinz-H\"ohne-Preis}
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\begin{document}

\title{Questionnaire}

\author{GI Fachgruppe Visual Computing in Biology and Medicine}
\date{Version (\today)}
\maketitle
\thispagestyle{fancy}

These questions are to be answered in order to properly submit an application to the medvis award 2023 for medical visualisation (Karl-Heinz-Höhne-Preis).

The full information about the application is available at \href{https://www.fg-medvis.de/appaward.html}{https://www.fg-medvis.de/appaward.html}.


\section{What is the relevance of your contribution(s)?
What is the relation to medical education, diagnostics, or treatment?}

\section{What is the originality of your contribution(s)?}

\section{What kind of progress to the issue has been reached?}

%\clearpage

\section{Which publications relate the most to the submitted?}

\section{To what extent was your contribution tested by users?}

\section{Alternative submissions}

The following work has already been submitted to or awarded by which other contest:

%none or name of the contest

\section{Personal indications}

\begin{tabular}{lp{11cm}}
	Name & \\
	First Name & \\
	Address & \\
	&\\
%(street, no, postal code, place) \\
	Phone & \\
	Email & \\
 	Employer & \\
	& \\
%(Please fill in name of the university or firm, department, and place.)
\end{tabular}


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\hspace{6cm} \= \hspace{7cm}\kill
\underline{\hspace{5cm}} \>\underline{\hspace{7cm}}\\
\small Place, date \> \small Signature\\
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\end{document}
