1. Disclosure Information 89th Annual Scientific Meeting <Speaker’s Name Here>
I have the following financial relationships to disclose: (select those that apply – delete those that do not)
Consultant for: <name here>
Speakers Bureau for: <name here>
Grant/Research support from: <name here>
Stockholder in: <name here>
Honoraria from: <name here>
Employee of: <name here>
I will not discuss off-label use and/or investigational use in my presentation
OR (select one and delete the other)
I will discuss the following off-label use and/or investigational use in my presentation:

2. Disclosure Information 89th Annual Scientific Meeting <Speaker’s Name Here>
I have no financial relationships to disclose. I will not discuss off-label use and/or investigational use in my presentation OR (select one – delete the other) I will discuss the following off-label use and/or investigational use in my presentation: