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MSHA 2026 Annual Continuing Education Conference Call for Presentations & Papers

1.Presenter's Complete Name and Credentials(Required.)
2.Presenter 1: Email Address(Required.)
3.Please enter a brief bio for the presenter (not to exceed 75 words):(Required.)
4.Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, gift, speaking fee, consulting fee, honoraria, ownership interest (e.g., stocks, stock options, or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial relationships can also include “contracted research” where the institution gets the grant and manages the funds and the individual is the principal or named investigator on the grant.


Do you have a Relevant Financial Relationship to Disclose?(Required.)
5.What was received? Please check all that apply
6.For each item you checked, please indicate the name of the relevant organization, company, product, etc.
7.Non-Financial relationships may include personal or professional roles, experiences, and background. The planners and instructional personnel must disclose to the Provider all non-financial relationships related to course content. The Provider will determine—through a guided discussion with the planners and instructional personnel—whether anything they disclosed cannot be resolved through disclosure to the attendees. Non-financial relationships must be disclosed during promotional efforts about the course and prior to the beginning of the course.

If there are no non-financial relationships, then this must be disclosed as well.




Do you have a Relevant Non-Financial Relationship to Disclose?(Required.)
8.What was received? Please check all that apply
9.For each item you checked, please indicate the name of the relevant organization, company, product, etc.
10.Presenter 2: Full Name and Credentials
11.Presenter 2: Email Address
12.Please enter a brief bio for presenter 2 (not to exceed 75 words):
13.Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, gift, speaking fee, consulting fee, honoraria, ownership interest (e.g., stocks, stock options, or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial relationships can also include “contracted research” where the institution gets the grant and manages the funds and the individual is the principal or named investigator on the grant.


Do you have a Relevant Financial Relationship to Disclose?
14.What was received? Please check all that apply
15.For each item you checked, please indicate the name of the relevant organization, company, product, etc.
16.Non-Financial relationships may include personal or professional roles, experiences, and background. The planners and instructional personnel must disclose to the Provider all non-financial relationships related to course content. The Provider will determine—through a guided discussion with the planners and instructional personnel—whether anything they disclosed cannot be resolved through disclosure to the attendees. Non-financial relationships must be disclosed during promotional efforts about the course and prior to the beginning of the course.

If there are no non-financial relationships, then this must be disclosed as well.




Do you have a Relevant Non-Financial Relationship to Disclose?
17.What was received? Please check all that apply
18.For each item you checked, please indicate the name of the relevant organization, company, product, etc.
19.Presenter 3: Full Name and Credentials
20.Presenter 3: Email Address
21.Please enter a brief bio for presenter 3 (not to exceed 75 words):
22.Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, gift, speaking fee, consulting fee, honoraria, ownership interest (e.g., stocks, stock options, or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial relationships can also include “contracted research” where the institution gets the grant and manages the funds and the individual is the principal or named investigator on the grant.


Do you have a Relevant Financial Relationship to Disclose?
23.What was received? Please check all that apply
24.For each item you checked, please indicate the name of the relevant organization, company, product, etc.
25.Non-Financial relationships may include personal or professional roles, experiences, and background. The planners and instructional personnel must disclose to the Provider all non-financial relationships related to course content. The Provider will determine—through a guided discussion with the planners and instructional personnel—whether anything they disclosed cannot be resolved through disclosure to the attendees. Non-financial relationships must be disclosed during promotional efforts about the course and prior to the beginning of the course.

If there are no non-financial relationships, then this must be disclosed as well.




Do you have a Relevant Non-Financial Relationship to Disclose?
26.What was received? Please check all that apply
27.For each item you checked, please indicate the name of the relevant organization, company, product, etc.
28.Please list any additional presenters, their email addresses, and brief bio below.

Presenters listed here will receive a separate disclosure form that MUST be completed by the CFP deadline for the session to be considered.