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Published bySydney Gibbs Modified over 9 years ago
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Japan Society for Hematopoietic Cell Transplantation COI disclosure Name of first author : e.g., John Doe I have no personal or financial interests to declare: I have no financial support from an industry source at the current presentation. Use the following slide to disclose any conflicts of interest Form 1-A: For oral presentation at the annual meeting with no conflicts of interest to declare.
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I currently have, or I have had in the past two years, an affiliation or financial interest with business corporation(s): (Yes or No, if “yes” include name of company) (1) Consulting fees : No (2) Stock / allotment : No (3) Patent royalties / licensing fees : No (4) Honoraria (e.g. lecture fees) : No (5) Fees for promotional materials : No (6) Research funding : Yes, Company X (7) Scholarship from corporation : Yes, Company Y (8) Corporate laboratory funding:Yes, Company Z (9) Others (e.g. trips, travel, or gifts)No Japan Society for Hematopoietic Cell Transplantation COI disclosure Name of first author : e.g., John Doe Form 1-B: For oral presentation at the annual meeting 、 with conflict of interest to declare.
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COI disclosure of first author (1) Consulting fees : No (2) Stock / allotment : No (3) Patent royalties / licensing fees : No (4) Honoraria (e.g. lecture fees) : No (5) Fees for promotional materials : No (6) Research funding : Yes, Company X (7) Scholarship from corporation : Yes, Company Y (8) Corporate laboratory funding:Yes, Company Z (9) Others (e.g. trips, travel, or gifts)No Use the following to disclose your conflict of interest for a poster presentation at the annual meeting. Form 1-C: Disclosure of conflict of interest As first author, I have no personal or financial interests to declare: I have no financial support from an industry source at the current presentation. OR
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