Faculty/Presenter Disclosure Slide 1

Slides:

Advertisements

Similar presentations

Faculty/Presenter Disclosure Faculty: [Speaker’s name] Relationships with commercial interests: – Grants/Research Support: PharmaCorp ABC – Speakers Bureau/Honoraria:

Advertisements

1 Agenda 1.Introductions & Sharing Learnings (75 mins) Hand out evaluation forms at beginning of session 2.Yellow Flags & Mental Health Tools (30 mins)

To be at the very first slide at the beginning of event WELCOME (may include your dates, logo of organization, etc.) Slide 1.

Expanding a Regional-based Program: Resource Matching and Referral and the Inter-LHIN Referral Model May 28 th, 2013.

Pain Management Module Learning Session 1.

Sample Disclosure Slides Information: A presenter must include Disclosure slides for each presentation – even if nothing to disclose Two slides are required.

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

Part 2. Faculty/Presenter Disclosure Faculty/Presenter:[insert name here] Relationships with commercial interests: Grants/research support:[insert company/organization.

Faculty/Presenter Disclosure Faculty: [Speaker’s name] Relationships with commercial interests: – Grants/Research Support: PharmaCorp ABC – Speakers Bureau/Honoraria:

Faculty/Presenter Disclosure Faculty: [name of speaker(s)] Relationships with commercial interests:  Grants/Research Support:  Speakers Bureau/Honoraria:

Sample Disclosure Slide for Presenters

Faculty/Presenter Disclosure Slide 1 Faculty: [Speaker’s name] Relationships with commercial interests: – Grants/Research Support: PharmaCorp ABC – Speakers.

Pain Management BounceBack Learning Session 3 Presenter’s name here Location here Date here.

Slide 1: Faculty/Presenter Disclosure

Faculty/Presenter Disclosure

Faculty/Presenter Disclosure

PRESENTATION NUMBER: PRESENTATION TITLE PRESENTER Author Block.

MOA role in End of Life Care

Arthritis and Low Back Pain

HOW LOW SHOULD YOU TARGET LDL-C?

Engaging Communities in the RAAM Clinic Process

Name of Program Date.

Faculty/Presenter Disclosure

Disclosure of Affiliations, Financial Support, and Mitigating Bias Speaker Name: Session Information: (Program Name, Session Title, Date) Affiliations:

HOW LOW SHOULD YOU TARGET LDL-C?

SLIDE 1: Scientific Planning Committee(SPC) / Organizing Planning Committee (OPC) Disclosure SPC/OPC Name Relationships with for-profit and/or non-profit.

Title of the presentation

Conflict of Interest Disclosure Form

Insert Your Photo or Logo Here

Disclosure Information 87th Annual Scientific Meeting Speaker’s Name Here I have the following financial relationships to disclose: (select those that.

Advanced Access & Office Efficiency Learning Session 2

Conflict of Interest Disclosure:

Disclosure Information 89th Annual Scientific Meeting I have the following financial relationships to disclose: (select those that.

Group Medical Visits Health Literacy Patient Self-Management

Faculty/Presenter Disclosure

Presenter Disclosure Presenters: [Speaker’s name]

Scientific Planning Committee (SPC) Disclosure Program Information:

Westin Wall Centre – Airport Ballroom

Disclosure of Affiliations, Financial Support, and Mitigating Bias Speaker Name: Affiliations: Please choose the statement that best describes your disclosure:

Presenter Disclosure Presenters: [Speaker’s name]

Faculty/Presenter Disclosure

Click to edit title Click to edit subtitle

The Scientific Planning Committee Acknowledgement Statement

Faculty/Presenter Disclosure

Faculty/Presenter Disclosure Relationships with commercial interests:

MSK TTT 2 October 23, 2013 Dr. Julia Alleyne

Faculty/Presenter Disclosure

Presentation Title Subtitle.

Scientific Planning Committee (SPC) Disclosure

Presentation Title Subtitle.

Presentation Title Subtitle.

Faculty/Presenter Disclosure

Faculty/Presenter Disclosure

Conflict of Interest Disclosure Form

Disclosure Information 90th Annual Scientific Meeting I have the following financial relationships to disclose: (select those that.

Presentation Title Subtitle.

Presenter Disclosure Dr. First Name Last Name – Presenter

Faculty/Presenter Disclosure

Faculty/Presenter Disclosure

Faculty/Presenter DISCLOSURE:

Faculty/Presenter Disclosure

Advanced Access/Office Efficiency

Conflict of Interest Disclosure Form DISCLOSURE

Name of Activity / Session

Faculty/Presenter Disclosure

Faculty / Presenter Disclosure

Conflict of Interest Disclosure Form

Faculty/Presenter Disclosure

Presentation transcript:

Faculty/Presenter Disclosure Slide 1 Speaker Name: Please choose the statement that best describes your disclosure: I have no relationships with for-profit or not-for-profit organizations. OR Relationships with for-profit or not-for-profit organizations Grants/Research Support: PharmaCorp ABC Speakers Bureau/Honoraria: XYZ Biopharmaceuticals Ltd. Consulting Fees: MedX Group Inc. Other: Employee of XXY Hospital Group

Disclosure of Financial Support Slide 2 This session/program has received financial support from [enter for-profit or not-for-profit organization] in the form of [describe support here – e.g. an educational grant]. This session/program has received in-kind support from [enter for-profit or not-for-profit organization] in the form of [describe support here – e.g. logistical support]. Potential for conflict(s) of interest: [Speaker/Faculty name] has received [payment/funding, etc.] from [organization supporting this program AND/OR organization whose product(s) are being discussed in this program]. [Supporting organization name] [developed/licenses/distributes/benefits from the sale of, etc.] a product that will be discussed in this

Mitigating Potential Bias Slide 3 [Explain how potential sources of bias identified in slides 1 and 2 have been mitigated]. Refer to “Quick Tips” document.