Disclosure Form to collect All Financial Relationships from Planners, Faculty, Speakers, Course Directors, Coordinators, Others
As a prospective planner or faculty member, we would like to ask for your help in protecting our learning environment from industry influence. Please complete the form below and return it to the Continuing Education (CE) Department at email@example.com by the deadline outlined by the course directors/planners/coordinators or CE staff.
The ACCME Standards for Integrity and Independence require that we disqualify individuals who refuse to provide this information from involvement in the planning and implementation of accredited continuing education. Thank you for your diligence and assistance. If you have questions, please contact us at firstname.lastname@example.org.