1. Financial Disclosures Financial interests, arrangements or affiliations that could be perceived as a real or apparent “conflict of interest” in the context of my participation in the CME activity are: category of relationship (e.g. consulting fees); name of commercial interest (e.g. COMPANY X); and relationship **OR** No conflict of interest to disclose.

2. or <Sample B –”Financial interests, arrangements or affiliations that could be perceived as a real or apparent “conflict of interest” in the context of my participation in the CME activity are:-- category of relationship (e.g. consulting fees); name of commercial interest (e.g. COMPANY X); and relationship> Financial Disclosures

3. Financial interests, arrangements or affiliations that could be perceived as a real or apparent “conflict of interest” in the context of my participation in the CME activity are: category of relationship (e.g. consulting fees); name of commercial interest (e.g. COMPANY X); and relationship **OR** There are no actual or potential conflict of interest in relation to this program

4. Financial Disclosures The following relationships exist related to this presentation: :No relationships to disclose -:Consulting fees from company X : Royalty income from company Y :Stock options in company Z (etc.)