Date: Thursday, February 2, 2012 and Friday, February 3, 2012

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Instructions: Please complete the evaluation form by checking the appropriate rating. Each presenter and individual session objectives must be evaluated separately.
Disclosure Declaration Memorandum

(a) Notice of requirements for successful completion: Learners must complete 80% of the activity,sign the attendance record, and return the white copy of the contract hour certificate to receive credit for this activity.

(b) Conflicts of interest: The speakers have no actual or potential conflict of interest in relation to the presentation.

(c) Commercial support: No commercial support has been received.

(d) Non-endorsement of products: The presence of any product, company, or corporation at this conference in no way signifies an endorsement of the product, company, or corporation by ANCC Commission on Accreditation, ANNA, or Heartland Kidney Network.

(e) Off-label use: No off-label use of any product will be presented at this conference.

(f) Vendors: Learners will receive a list of vendors during the activity.

The memorandum has been created and distributed to fulfill an American Nurses Credentialing Center's Commission on Accreditation criterion.

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