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Faculty/Presenter Disclosure Slide 1

Faculty/Presenter Disclosure Slide 1. Faculty: [Speaker’s name] Relationships with commercial interests: Grants/Research Support: PharmaCorp ABC Speakers Bureau/Honoraria: XYZ Biopharmaceuticals Ltd. Consulting Fees: MedX Group Inc. Other: Employee of XXY Hospital Group.

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Faculty/Presenter Disclosure Slide 1

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  1. Faculty/Presenter DisclosureSlide 1 Faculty: [Speaker’s name] Relationships with commercial interests: Grants/Research Support: PharmaCorp ABC Speakers Bureau/Honoraria: XYZ Biopharmaceuticals Ltd. Consulting Fees: MedX Group Inc. Other: Employee of XXY Hospital Group

  2. Disclosure of Commercial SupportSlide 2 • This program has received financial support from [organization name]in the form of [describe support here – e.g. an educational grant]. • This program has received in-kind support from [organization name]in the form of [describe support here – e.g. logistical support]. • Potential for conflict(s) of interest: • [Speaker/Faculty name] has received [payment/funding, etc.] from [organization supporting this program AND/OR organization whose product(s) are being discussed in this program]. • [Supporting organization name] [developed/licenses/distributes/benefits from the sale of, etc.] a product that will be discussed in this program: [insert generic and brand name here].

  3. Mitigating Potential BiasSlide 3 • [Explain how potential sources of bias identified in slides 1 and 2 have been mitigated]. • Refer to “Quick Tips” document

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