Financial Interest/ Affiliation Name of Company(s)

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Financial Interest/ Affiliation Name of Company(s) I have/had an affiliation (financial or otherwise) with a commercial organization that may have a direct or indirect connection to the content of my presentation(s). Financial Interest/ Affiliation Name of Company(s) Grant/Research Support Employment/Honoraria/Consulting Fees/Travel expenses Major Stock Shareholder Membership on an advisory panel, standing committee, or board of directors Other Financial or Material Interest

I do not have any affiliation (financial or otherwise) with a commercial organization that may have a direct or indirect connection to the content of my presentation(s)