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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.

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, when conflicts of interest to disclose exist Form 1 A sample slide for an oral or poster presentation to disclose COI status , when conflicts of interest to disclose exist Japanese Society for Adult Congenital Heart Disease COI Disclosure 　 Name of First Author : ○○　○○ all names of co-authors: △△　△△、 □□　□ If “yes”, leave the relevant item (s) and give the name (s) of company/organization. There is no need to disclose the amount. Trust research/joint research funds:　　　○○pharmaceutical company 　　Scholarship fund:　○○pharmaceutical company 　　Affiliation with Endowed Department:　　yes（○○pharmaceuticals）