CME Disclosure Form

It is the policy of Natividad Medical Center to ensure balance, objectivity, independence, and scientific rigor in all CME activities.  Anyone engaged in activity content development, planning, or presentation must complete this form. 
There is no minimum threshold; we ask that you disclose all financial relationships, regardless of the amount, with ineligible companies.  

Question Title

* 1. Your Name

Question Title

* 2. Have you had a financial relationship in the previous 24 months with an ineligible company (formerly "commercial interest"), as defined below?


An ineligible company is defined as “those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.” The ACCME does not consider providers of clinical service directly to patients to be ineligible companies.

Ineligible Companies include:
  • Advertising, marketing, or communication firms whose clients are ineligible companies
  • Bio-medical startups that have begun a governmental regulatory approval process
  • Compounding pharmacies that manufacture proprietary compounds
  • Device manufacturers or distributors                             
  • Diagnostic labs that sell proprietary products
  • Growers, distributors, manufacturers or sellers of medical foods and dietary supplements
  • Manufacturers of health-related wearable products
  • Pharmaceutical companies or distributors
  • Pharmacy benefit managers
  • Reagent manufacturers or sellers