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Published byAdi Sumadi Modified over 5 years ago
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JDDW COI Disclosure All Presenters: ○○ ○○, ○○ ○○ … ○○ ○○ (Please state the names of the lead presenter and all co-presenters) Affiliated Organizations: Univ. of ○○, Dept. of ○○ or ○○ Hospital, Dept. of ○○ etc. COI Related to This Presentation ①Advisor: None ②Stock Ownership/Profits: None ③Royalties: None ④Lecture Fees: None ⑤Manuscript Fees: None ⑥Consigned/Joint Research Expenses: Yes (○○ Inc.) ⑦Scholarship Donations: Yes (○○ Inc.) ⑧Course Affiliation: Yes (○○ Inc.) ⑨Gifts & Other Remuneration: None
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