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.

Slides:

Advertisements

Similar presentations

様式１AB (Form 2-A)Disclosure of Conflict of Interest in Oral Presentation 　　　　　　　　 When there is no conflict of interest to declare Japan Epilepsy Society.

Advertisements

Please use the sample slide format to disclose COI status

Subject name：□□□□□□□□□□□□□□□□

, when no conflicts of interest to disclose exist

【Sample Slide 2】 For those who have the conflict of interest to disclose Japanese Society for Dialysis Therapy COI Disclosure 　 Name of First Author：　○○　○○

No conflicts of interest to disclose

様式１AB （Ｆｏｒｍ　4－C）　Disclosure of the state of conflict of interest at the end of a poster at a poster session Lead presenter: There are no companies, etc.

for Respiratory Care and Rehabilitation

CCT2017 COI Disclosure Name of First Author : XXXXXXXXXXXXXX

COI Disclosure of First Author

Please use the sample slide format to disclose COI status

COI Disclosure of First Author

The Japanese Association of Cardiovascular Intervention and Therapeutics COI Disclosure　 Name of First Author : Use Form 1-B when you have conflicts of.

The Japanese Circulation Society COI Disclosure Name of Authors :

Japanese Society of Allergology COI Disclosure Name of lead presenter

　*Please use this slide template when there is no

Conflict of Interest Disclosure

Conflict of Interest Disclosure

The Japanese Circulation Society COI Disclosure Name of Authors :

The Japanese Circulation Society COI Disclosure Name of Authors :

At the end of poster presentation, disclose COI status.

TOPIC 2018 COI Disclosure Name of Author :

International Society for Heart Research

様式１AB （Form4－Ａ）　If there is no state of conflict of interest requiring disclosure The Japanese Society of Neurology (JSN) ＣＯＩ Disclosure 　 Name of Lead.

Disclose COI statement

Disclosure of conflict of interest by lead presenter

様式１AB （Form4－Ａ）　If there is no state of conflict of interest requiring disclosure The Japanese Society of Neurology (JSN) ＣＯＩ Disclosure 　 Name of Lead.

The 46th Congress of the Japanese Headache Societhy Disclosure of COI Name of head presenter,　names of co-authors　 Name of affiliation Businesses,

CCT2018 COI Disclosure Name of First Author : XXXXXXXXXXXXXXXXX

Form 1-A　　(There is a state of conflict of interest (in the past three years) requiring disclosure) The Japanese Society of Gastroenterology (JSGE) COI.

Subject name：□□□□□□□□□□□□□□□□

, when no conflicts of interest to disclose exist

Use the following slide to disclose any conflicts of interest

The Japanese Circulation Society COI Disclosure Name of Authors :

様式１AB （Form4－Ａ）　If there is no state of conflict of interest requiring disclosure The Japanese Society of Neurology (JSN) ＣＯＩ Disclosure 　 Name of Lead.

Subject name：□□□□□□□□□□□□□□□□

様式１AB （Form4－Ａ）　If there is no state of conflict of interest requiring disclosure The Japanese Society of Neurology (JSN) ＣＯＩ Disclosure 　 Name of Lead.

Conflict of Interest Disclosure

様式１AB （Ｆｏｒｍ　4－C）　Disclosure of the state of conflict of interest at the end of a poster at a poster session Lead presenter: There are no companies, etc.

Please use the sample slide format to disclose COI status.

様式１AB （Ｆｏｒｍ　4－C）　Disclosure of the state of conflict of interest at the end of a poster at a poster session Lead presenter: There are no companies, etc.

Conflict of Interest Disclosure

Japan Society of Ningen Dock COI Disclosure First author: ○○ ○○

Post of executive /consultant： AB Pharma Co.,

The Japanese Orthodontic Society COI Disclosure

Form１－A　　　The 24th Annual Meeting of Japan Society of Gene and Cell Therapy COI Disclosure　 Lead presenter：　○○　○○ In connection with the presentation,

ＪＤＤＷ　ＣＯＩ Disclosure 　 All Presenters：　○○ ○○, ○○　○○ … ○○　○○ (Please state the names of the lead presenter and all co-presenters) Affiliated Organizations：　Univ.

for Respiratory Care and Rehabilitation

The 13th Asian Epilepsy Surgery Congress AESC2019 　 Disclosure of COI Name of head presenter,　Names of co-authors　 Name of affiliation There are no.

Lead presenter COI Disclosure

Please use the sample slide format to disclose COI status.

様式１AB （Ｆｏｒｍ　4－C）　Disclosure of the state of conflict of interest at the end of a poster at a poster session Lead presenter: There are no companies, etc.

Disclosure of head presenter’s COI

JSHILC2019　ＣＯＩ Disclosure 　 All Presenters：　○○ ○○, ○○　○○ … ○○　○○ (Please state the names of the lead presenter and all co-presenters) Affiliated Organizations：　○○○○○○,

JSHILC2019 Disclosure 　 All Presenters：　○○ ○○, ○○　○○ … ○○　○○ (Please state the names of the lead presenter and all co-presenters) Affiliated Organizations：　○○○○○○,

CCT2018 COI Disclosure Name of First Author : XXXXXXXXXXXXXX

Conflict of Interest Disclosure

The 24ｔｈ Annual Meeting of the Japanese Association for Coronary Artery Surgery Disclosure of COI Name of head presenter,　names of co-authors　 Name.

COI Disclosure of First Author

Please use the sample slide format to disclose COI status at oral and poster presentation There are no conflicts of interest for the past three years to.

　*Please use this slide template when there is no

COI Disclosure of First Author

The sample slide format is presented to disclose COI status, when there are no conflicts of interest. This should be used when giving a presentation at.

様式１AB (Form 2-A)Disclosure of Conflict of Interest in Oral Presentation 　　　　　　　　 When there is no conflict of interest to declare Japan Epilepsy Society.

様式１AB （Ｆｏｒｍ　4－C）　Disclosure of the state of conflict of interest at the end of a poster at a poster session Lead presenter: There are no companies, etc.

Form１－A　　 Japan Gastroenterological Endoscopy Society COI Disclosure 　 Lead presenter：　○○　○○ In connection with the presentation, we disclose COI with.

Please use the sample slide format to disclose COI status

様式１AB （Form4－Ａ）　If there is no state of conflict of interest requiring disclosure The Japanese Society of Neurology (JSN) ＣＯＩ Disclosure 　 Name of Lead.

様式１AB （Ｆｏｒｍ　4－C）　Disclosure of the state of conflict of interest at the end of a poster at a poster session Lead presenter: There are no companies, etc.

COI Disclosure For speakers with a COI to declare

Presentation transcript:

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 with the presentation which should be disclosed　 1. Consultant:　　　　　　　　　　　 None 　　2. Stock ownership/profit:　　　 None 　　3. Patent royalty:　　　　　　　　　　 None 　　4. Lecture honorarium：　　　　　　 None 　　5. Manuscript fee:　　　　　　　　 None 　　6. Commissioned research/ collaborative research fund:　 XX Pharmaceutical 　　7. Scholarship contribution: XX Pharmaceutical 　　8. Endowed chair affiliation: Yes (XX Pharmaceutical) 　　9. Gifts and other remunerations: None 10. Main source of income (salary etc.): XX Hospital/University