1. Faculty/Presenter Disclosure
Faculty: [Speaker’s name]
Relationships with financial interests:
Grants/Research Support: PharmaCorp ABC
Speakers Bureau/Honoraria: XYZ Biopharmaceuticals Ltd.
Consulting Fees: MedX Group Inc.
Patents:
Other: Employee of XXY Hospital Group
Instructions:
This slide must be visually presented to the audience AND talked through by the speaker.
Where a faculty/presenter has no relationships to disclose, simply indicate ‘‘Not Applicable’’ under the heading ‘‘Relationships with financial interests’’.
Speakers must indicate direct financial relationships with both for-profit groups (e.g., relationships with industry, or communications firms) and not-for-profit groups (e.g., charitable organizations, government, patient advocacy groups, research groups, etc.)
Speakers must also indicate where and in what capacity they are employed (e.g., position in name of company, hospital, university or owner operated clinic / company)

2. Disclosure of Commercial Support
This program has received financial support from [organization name] in the form of [describe support here – e.g. an educational grant].
This program has received in-kind support from [organization name] in the form of [describe support here – e.g. logistical support].
Potential for conflict(s) of interest:
[Speaker/Faculty name] has received [payment/funding, etc.] from [organization supporting this program AND/OR organization whose product(s) are being discussed in this program].
[Supporting organization name] [developed/licenses/distributes/benefits from the sale of, etc.] a product that will be discussed in this program: [insert generic and brand name here].
Instructions:
This slide must be visually presented to the audience OR verbalized by course/program organizers.
Where the event receives any external support, all forms of support should be outlined: whether in-kind (loan of equipment or office time, for example) or financial, whether from not-for-profit organizations (charities, disease-specific support groups) or from commercial companies.
Where a program has received no commercial support (this includes monies for food, logistics assistance such as registration, AV set-up, etc.), simply indicate ‘‘No Commercial Support’’ on this slide.
Exhibitor fees are not considered financial support and are not declared.

3. Mitigating Potential Bias
Sponsor representatives are not members of the Planning Committee of the program
The Planning Committee carefully chooses the topics for the program in order to ensure that the principles of scientific integrity, objectivity and balance have been respected
The Planning Committee chair and members have individual discussions with each speaker regarding expected learning outcomes and teaching formats
The Planning Committee communicates the course learning objectives and requirement for scientific integrity, as well as instruction on conflict of interest disclosure and managing bias, to each speaker, facilitator and moderator
Instructions:
1) This slide must be visually presented to the audience OR verbalized by course/program organizers.
2) Where there are no potential biases identified by speakers AND there is no commercial support for the program, simply indicate ‘‘Not Applicable’’ on this slide.
Where potential conflicts exist, the Planning Committee or Program Chair must use this slide to explain the measures taken to mitigate bias.
3) Edit this slide to describe bias mitigation measures your organization has taken, or plans to take. Additional idease for mitigating bias are outlined in your College’s CPD web pages.