Content Review (Managing a Speaker's conflict of interest)

Conflict of Interest resolution

Disclosure of a relevant financial relationship requires that the conflict of interest be resolved prior to the start of the CME activitiy. The conflict must be managed by the Department Chair, CME Activity director or Faculty Designee in collaboration with the UUCME office.

On your previous evaluation, you indicated that one way to manage this conflict of interest would be by completing a review of the Speaker's content. Please indicate completion and results of that content review here.

The reviewer must not have a conflict of interest. See the UUCME website for defintions of conflict of interest and relevant financial relationships, as needed. Contact UUCME with any questions (CME.Office@hsc.utah.edu or (801) 581-6886).

To complete this form, you must reference the Speaker's disclosed relevant financial relationships which should have been provided to you along with the link to this survey. You must also have communicated with the Speaker about the plan to manage their conflicts and have access to their planned content.

Question Title

* 1. About the activity

Name of Activity

Date

Question Title

* 2. Speaker's Name

Question Title

* 3. About you (the reviewer)

Name of reviewer

Title of reviewer

Date of review

Question Title

* 4. Did you review the Speaker's relevant financial relationships?

Yes (please continue)

No (please request the form, if needed, & review the conflicts before proceeding)

Question Title

* 5. Have you communicated and come to an agreement with the Speaker about the conflict(s) will be managed?

Yes, we have come to an agreement for how the Speaker will manage their conflicts of interest. (please continue)

No (please do this before completing this form)

Question Title

* 6. Have you completed your review of the Speaker's content (ex. slides)?

Yes (please continue)

No (please return once completed)