1. COI

This policy is to ensure balance, independence, objectivity, and scientific rigour in all our continuing education activities. We must disclose to the audience any real or apparent conflicts of interest (COI) with commercial interests whose products or services may be mentioned in the activity.

The ACCME, ANCC, and ACPE define a “commercial interest” as any proprietary entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME, ANCC, and ACPE do not consider providers of clinical service directly to patients to be commercial interests. A COI exists when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of the education about the product or services of that commercial interest. As the accredited provider, we are responsible for collecting information from instructors, planners, and managers of continuing education content and resolving those conflicts prior to the commencement of the activity. The intent of the COI resolution process is to assure that provider, faculty, and planner financial relationships with commercial interests and resultant loyalties do not supersede the public interest in the design and delivery of certified activities for the profession. Any financial relationship with a commercial interest in the last 12 months is considered a conflict of interest.

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* 1. Please type your name.

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* 2. What is your email address?

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* 3. Please type your credentials (ie MD, ND, LAc, NP, AHP).

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* 4. What is your role in the activity? (check all that apply).

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* 5. The use of employees of ACCME-defined commercial interest as faculty or planners or in other roles where they are in a position to control the CME content is prohibited with the exception of a few specific situations identified by the ACCME. Are you employed by a commercial interest?

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* 6. Are you a Licensed Acupuncturist:

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* 7. Please provide us with your license TYPE and NUMBER.

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* 8. Do you have a conflict of interest (COI) with an ACCME defined commercial interest?

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* 9. If you answered YES above you MUST tells us your ROLE on the proprietary entities producing health care goods or services, consumed by, or used on, patients, with the exemption of non-profit or government organizations and non-health care related companies with which you or your spouse/partner have, or have had, a relevant financial relationship within the past 12 months. For this purpose, we consider the relevant financial relationships of your spouse or partner that you are aware of to be yours. Please tell us the NAME of the commercial interest (e.g Advisory Board -ASTRAZENECA; Royalty - Pfizer etc).

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* 10. If you reported relationships above, will the relationships impact your ability to present an unbiased presentation?

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* 11. ATTESTATION ( you must check ALL).

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* 12. Electronic Signature

ACCME STANDARDS FOR COMMERCIAL SUPPORT (SCS):

As an ACCME, ANCC, ACPE, and CDR accredited provider, the provider require that faculty members comply with the Standards for Commercial Support (SCS). We will be disclosing to participants if this activity is supported by an educational grant from a commercial interest. As a faculty member, you are required to disclose any personal financial interest or relationship that you may have with any commercial interest or the manufacturer(s) of any commercial product that is discussed in the activity.

The educational CME/CNE provider has implemented a process that requires everyone who is in a position to control the content of an activity to disclose all relevant financial relationships with any commercial interest. In addition, should it be determined that a COI exists, this will need to be resolved prior to the activity.

We will utilize the information reported on this form to 1) determine if a conflict exists, 2) resolve the conflict by initiating a content validation process, and 3) advise learners of this information.

Please note that the SCS require all providers to disqualify instructors, planners, and managers that do not supply this information.

GUIDELINES FOR CONTENT DEVELOPMENT:

This educational activity must follow the standards for CME established by the ACCME, AMA, ANCC, ACPE and FDA. Accordingly, please adhere to the following guidelines:

• Content should cover and teach to the learning objectives

• Content must be scientifically rigorous, present a fair-balanced discussion of all therapeutic options and products, be evidence based, and unbiased

• As much as possible, the content should present generic names of products. If trade names must be used, the names of multiple products should be used for balance

• Content must be free from commercial bias, it should not advance the proprietary interests of any commercial company

• Any unlabeled/unapproved uses of drugs or products discussed in the content must be disclosed to the audience in either the content or verbally at the time of presentation

• Any training or utilization by a commercial interest (eg. speakers’ bureau) will not in any way include the promotional aspects or industry slides in the content of a continuing education presentation

• Slides or handout materials must not contain any commercial graphic, logo, or product message

• All published data, reference studies and articles cited in the content must be properly referenced on slides and handout materials

• If providing recommendations involving clinical medicine, all recommendations should be based on evidence that is accepted within the professions of medicine as adequate justification for their indications and contraindications in the care of patients

• All scientific research referred to, reported or used in support of justification of patient care recommendations should conform to the generally accepted standards of experimental design, data collection and analysis
COMMERCIAL INTEREST:

The ACCME defines a “commercial interest” as any proprietary entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME, ANCC, and ACPE do not consider providers of clinical service directly to patients to be commercial interests.
FINANCIAL RELATIONSHIPS:

Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefits. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. ACCME and pertinent accrediting bodies consider relationships of the person involved in the activity to include financial relationships of a spouse or partner.
RELEVANT FINANCIAL RELATIONSHIPS:

ACCME and pertinent accrediting bodies focus on financial relationships with commercial interests in the 12-month period preceding the time that the individual is being asked to assume a role controlling the content of the activity. ACCME and pertinent accrediting bodies have not set a minimum dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME defines “’relevant’ financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest.
CONFLICTS OF INTEREST:

Circumstances create a conflict of interest when an individual has an opportunity to affect content about products or services of a commercial interest with which he/she has a financial relationship.



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