ACU 2024 Annual Conference Speaker/Presenter Form
Relevant Financial Relationships
ACU plans to offer Continuing Medical Education (CME) credit for the 2023 Annual Conference. As such, we aim to meet the Accreditation Council for Continuing Medical Education's (ACCME) expectations for our practice of continuing medical education.
Anyone involved in content development and presentation for your proposed session must disclose all relevant financial relationships with any commercial interest.
NOTE: In addition, should it be determined that a conflict of interest exists as a result of a financial relationship you may have, this will need to be resolved before the activity.
This information is necessary for us to be able to move to the next steps in planning this CME activity. If you refuse to disclose relevant financial relationships, you will be disqualified from being a part of the planning and implementation of this CME activity.
Please disclose all financial relationships with ineligible companies within the prior 24 months of the completion date of this form.
Ineligible companies are those whose primary business is producing, marketing, selling, reselling, or distributing health care products used by, or on, patients. Relationship types including but not limited to employee, researcher, consultant, advisor, speaker, independent contractor (including contracted research), royalties or patent beneficiary, executive role, and ownership interest. Individual stocks and stock options should be disclosed; diversified mutual funds do not need to be disclosed. Research funding from ineligible companies should be disclosed by the principal or named investigator even if that individual’s institution receives the research grant and manages the funds.
Also, please review ACU's policy on full disclosure.
Please complete this form no later than Friday, February 9, 2024.
ACU plans to offer Continuing Medical Education (CME) credit for the 2023 Annual Conference. As such, we aim to meet the Accreditation Council for Continuing Medical Education's (ACCME) expectations for our practice of continuing medical education.
Anyone involved in content development and presentation for your proposed session must disclose all relevant financial relationships with any commercial interest.
NOTE: In addition, should it be determined that a conflict of interest exists as a result of a financial relationship you may have, this will need to be resolved before the activity.
This information is necessary for us to be able to move to the next steps in planning this CME activity. If you refuse to disclose relevant financial relationships, you will be disqualified from being a part of the planning and implementation of this CME activity.
Please disclose all financial relationships with ineligible companies within the prior 24 months of the completion date of this form.
Ineligible companies are those whose primary business is producing, marketing, selling, reselling, or distributing health care products used by, or on, patients. Relationship types including but not limited to employee, researcher, consultant, advisor, speaker, independent contractor (including contracted research), royalties or patent beneficiary, executive role, and ownership interest. Individual stocks and stock options should be disclosed; diversified mutual funds do not need to be disclosed. Research funding from ineligible companies should be disclosed by the principal or named investigator even if that individual’s institution receives the research grant and manages the funds.
Also, please review ACU's policy on full disclosure.
Please complete this form no later than Friday, February 9, 2024.