Disclosures of Potential Conflicts

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Sample Disclosure Slide for Presenters. Presentation Title Presenter’s Name My disclosure along with my co-authors is listed in the disclosure index on.

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Disclaimer The views and opinions expressed in the following PowerPoint slides are those of the individual presenter and should not be attributed to Drug.

Sample Disclosure Slide for Presenters

The Japanese Association for Thoracic Surgery COI Disclosure The author has no conflict of interest to disclose with respect to this presentation. Presenting.

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Disclosure Slide Templates

Faculty Disclosure Off-Label Product Use

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Disclosures of Potential Conflicts

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FIRST LAST Name Title of Session Title of Presentation.

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FINANCIAL DISCLOSURES

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Welcome to the 39th ESPEN Congress

The Japanese Association for Thoracic Surgery COI Disclosure

Conflict of Interest Disclosure

In relation to this presentation, the following COI to be disclosed:

Speaker Name: Disclosure of Relevant Financial Relationships

Disclosure of conflict of interest by lead presenter

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Faculty Disclosure Off-Label Product Use

Disclosures Relevant financial relationships in the past twelve months by presenter or spouse/partner. Employment: Company Name(s) Speakers Bureau:

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The Japanese Association for Thoracic Surgery COI Disclosure

The Japanese Circulation Society COI Disclosure Name of Authors :

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The Japanese Association for Thoracic Surgery COI Disclosure

Speaker Name: Disclosure of Relevant Financial Relationships

The Japanese Association for Thoracic Surgery COI Disclosure

様式１AB Movement Disorder Society of Japan Disclosure of conflict of interest Name of presenter: XX XX Companies etc. with a conflict of interest relation.

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The Japanese Association for Thoracic Surgery COI Disclosure

The Japanese Association for Thoracic Surgery COI Disclosure

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Conflict of Interest Disclosure , Salary: Royalty: Receipt of Intellectual Property Rights/Patent Holder: Consulting Fees.

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Financial and Other Disclosures

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Conflict of Interest Disclosure Form DISCLOSURE

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Declaration of conflict of interest

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Conflict of Interest Disclosure <First Name> <Last Name>, <Degree>

Presenter Disclosure Information (SAMPLE DISCLOSURE SLIDE)

Presentation transcript:

Disclosures of Potential Conflicts Source Research Funding Advisor/ Consultant Employee Speakers’ Bureau Books, Intellectual Property In-kind Services (example: travel) Stock or Equity Honorarium or expenses for this presentation or meeting Your second slide should begin your conflicts of interest and your disclosures. Remember to list both the company and nature of the conflict. Don’t use logos Conflict of Interest/Disclosures must be your second slide

Disclosure All medication suggestions in this presentation are off-label uses. None of the medication presented has been approved for use in children. You MUST disclose off-label use!