1. Disclosure
I currently have no relationships of any kind with any company whose products or services in any way relate to the practice of medicine, medical education or research.
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2. Disclosure
In the interest of full disclosure, Dr. _____ (or insert immediate family member’s name) is a paid [consultant, educational lecturer, researcher, employee - family member, etc] for [Insert company’s name].
This company’s products or services in no way relate to the content I am presenting.
If you have questions, please contact me or Dr. Gerald Sterling – Senior Associate Dean of Education

3. Disclosure
In the interest of full disclosure, Dr. _____ (or insert immediate family member’s name) is a paid [consultant, educational lecturer, researcher, employee – family member, etc] for [Insert company’s name] or receives research support from [Insert company’s name]
I attest that this financial relationship has not influenced the content of my presentation. If you have questions, please contact me or Dr. Gerald Sterling – Senior Associate Dean of Education