ACHI is pleased to welcome you as faculty for our 15th annual conference, March 14-16, 2018 in Atlanta! We look forward to working with you over the coming months. To ensure that we support you in your faculty role, we have established quality standards for your participation. All provisions of these standards are designed to set and communicate expectations, clarify performance requirements and enhance the quality of the ACHI-faculty partnership.

Please review each section below and then sign and submit the Faculty Disclosure & Permissions Statement to confirm your place on the agenda. Please feel free to contact us at achiconference@aha.org if you have any questions.

RECORDING POLICY
Your presentation may be recorded, marketed and distributed under the auspices of ACHI. Your rights of ownership of your material will remain unaffected, and you will be free to use your own material in any manner you desire at any time in the future. Your acceptance of an invitation to make a presentation at the conference implies consent to the marketing and distribution of your recorded presentation unless we negotiate otherwise, and you waive claims to any payment that may be received as a consequence thereof by ACHI.

PUBLICATION POLICY
ACHI may publish materials from the conference in its publications and websites. You waive claims to any payment that may receive as a consequence thereof by ACHI. Please indicate on the signature page whether you provide permission to publish your materials with proper credit.

FACULTY DISCLOSURE POLICY
All faculty members are expected to disclose any significant financial interest or other relationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation. (Significant financial interest or other relationships can include such things as grants or research support, employee, consultant, major stockholder, member of speaker’s bureau, etc.) The intent of this disclosure is not to prevent a presenter with a significant financial interest or other relationship from making a presentation, but rather to provide participants with information from which they can make their own judgments. Any relationships will be noted in the conference materials received by participants. 

QUALITY GUARANTEE
Association for Community Health Improvement guarantees to:
-Establish a timeline detailing specific due dates for providing conference materials and taking other actions.
-Update faculty on logistics, registration, curriculum refinement and other planning issues.
-Respond promptly to faculty questions and concerns before and during the conference program.
-Manage the on-site experience to create an environment that enables faculty to optimize performance.

As faculty, I guarantee to:
-Respect ACHI’s policy of no selling of services, products or future consulting assignments during the presentation
-Customize presentation information to the particular conference audience.
-Arrive at the conference site in sufficient time to organize thoughts and A/V before presenting. 
-Adhere to established due dates for providing presentation materials and other materials and/or forms; if a due date cannot be met, immediately notify ACHI.
-Provide a copy of the presentation by March 2, 2018, for reproduction in the conference mobile app.
- Notify ACHI immediately if any situation arises that adversely affects my participation.
Please complete the information below to confirm you participation as faculty for the 2018 ACHI National Conference

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* 1. Permission to audio or video record your session

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* 2. Permission to publish materials from my presentation (with appropriate credit given)

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* 3. Will your presentation include discussion of any commercial products or services?

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* 4. If yes, do you have a significant financial interest or other relationship with the manufacturer(s) of any of the products or provider(s) of any of the services you intend to discuss?

I agree to present at the ACHI National Conference March 14-16, 2018.  I have reviewed the Faculty Policies & Quality Guarantee and agree to its provisions regarding my relationship with the Association for Community Health Improvement as faculty for the conference.

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* 5. Name

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* 6. Date

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* 7. Presentation Title

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