Disclosure Slides Template and Examples 0. Faculty Disclosure Information Elements 1 1.Name of...

5
Disclosure Slides Template and Examples 1

Transcript of Disclosure Slides Template and Examples 0. Faculty Disclosure Information Elements 1 1.Name of...

Page 1: Disclosure Slides Template and Examples 0. Faculty Disclosure Information Elements 1 1.Name of Faculty 2.Title of Presentation 3.Name of Commercial Interest.

Disclosure Slides

Template and Examples

1

Page 2: Disclosure Slides Template and Examples 0. Faculty Disclosure Information Elements 1 1.Name of Faculty 2.Title of Presentation 3.Name of Commercial Interest.

Faculty Disclosure Information Elements

2

1. Name of Faculty

2. Title of Presentation

3. Name of Commercial Interest

4. Information about nature of relationship, financial disclosure means the role they play or service they provide in exchange for some form of compensation (e.g., employment, management position, independent contractor including contracted research, consulting, speaking and teaching, membership on advisory committees or review panels and board membership).

5. Repeat 2 and 3 for each commercial interest

6. Unlabeled/Unapproved Uses Disclosure: (Does faculty intend to discuss drug usage that are off label? If so, include that information here.)

7. If faculty has no relevant financial relationships – that must be disclosed as well. “No relevant financial relationship(s) exist.”

Page 3: Disclosure Slides Template and Examples 0. Faculty Disclosure Information Elements 1 1.Name of Faculty 2.Title of Presentation 3.Name of Commercial Interest.

Presenter Disclosure Information[Insert presenter name][insert title of presentation]

FINANCIAL DISCLOSURE:[Insert description of relationship with commercial

supporter and name of commercial supporter.]

UNLABELED/UNAPPROVED USES DISCLOSURE:[Describe intended unlabeled/unapproved use in

presentation.]3

Page 4: Disclosure Slides Template and Examples 0. Faculty Disclosure Information Elements 1 1.Name of Faculty 2.Title of Presentation 3.Name of Commercial Interest.

Presenter Disclosure InformationJohn Q. Smith, MDDilation of Coronary Stenosis

FINANCIAL DISCLOSURE:Grants/Research Support: ABC PharmaceuticalsSpeakers Bureau: XYZ Manufacturing

UNLABELED/UNAPPROVED USES DISCLOSURE:Use of L-Arginine in patients with acute coronary

syndrome is investigational only

4SAMPLE SLIDE

Page 5: Disclosure Slides Template and Examples 0. Faculty Disclosure Information Elements 1 1.Name of Faculty 2.Title of Presentation 3.Name of Commercial Interest.

Presenter Disclosure InformationJohn Q. Smith, MDDilation of Coronary Stenosis

FINANCIAL DISCLOSURE:No relevant financial relationship exists

5SAMPLE SLIDE


Mandatory Disclosure Name of the Institution

Mandatory Disclosure Name of the Institution

MANDATORY DISCLOSURE DISCLOSURE 2018-19.pdf · 2019-12-06 · MANDATORY DISCLOSURE 1. NAME OF THE INSTITUTION Kamla Nehru Institute of Management and Technology Faculty of Pharmacy

MANDATORY DISCLOSURE DISCLOSURE 2018-19.pdf · 2019-12-06 · MANDATORY DISCLOSURE 1. NAME OF THE INSTITUTION Kamla Nehru Institute of Management and Technology Faculty of Pharmacy

Name of Presenter Presenter’s Title Presenter Disclosure text here presenter disclosure text here presenter disclosure text here Presenter Disclosure.

Name of Presenter Presenter’s Title Presenter Disclosure text here presenter disclosure text here presenter disclosure text here Presenter Disclosure.

MANDATORY DISCLOSURE Name of the

MANDATORY DISCLOSURE Name of the

Mandatory Disclosure - CHARUSATcharusat.ac.in/Download/iiim_md_19jul2013.pdf · Mandatory Disclosure ... 12 Name of the Department Faculty of ... Diamond Infosystem Ltd. Marketing

Mandatory Disclosure - CHARUSATcharusat.ac.in/Download/iiim_md_19jul2013.pdf · Mandatory Disclosure ... 12 Name of the Department Faculty of ... Diamond Infosystem Ltd. Marketing

Faculty Disclosure - ACOFP

Faculty Disclosure - ACOFP

SUBJECT SUBJECT NAME ACRONYMS FACULTY NAME

SUBJECT SUBJECT NAME ACRONYMS FACULTY NAME

Part 2. Faculty/Presenter Disclosure Faculty/Presenter:[insert name here] Relationships with commercial interests: Grants/research support:[insert company/organization.

Part 2. Faculty/Presenter Disclosure Faculty/Presenter:[insert name here] Relationships with commercial interests: Grants/research support:[insert company/organization.

MANDATORY DISCLOSURE - knmt.org.in · MANDATORY DISCLOSURE 1. NAME OF THE INSTITUTION Kamla Nehru Institute of Management and Technology Faculty of Pharmacy Faridipur ... Dr. B.D.

MANDATORY DISCLOSURE - knmt.org.in · MANDATORY DISCLOSURE 1. NAME OF THE INSTITUTION Kamla Nehru Institute of Management and Technology Faculty of Pharmacy Faridipur ... Dr. B.D.

MANDATORY DISCLOSURE 1. Name of the Institution SETHU ...sethu.ac.in/MandatoryDisclosure.pdf · MANDATORY DISCLOSURE 1. Name of the Institution Name of the Institution SETHU INSTITUTE

MANDATORY DISCLOSURE 1. Name of the Institution SETHU ...sethu.ac.in/MandatoryDisclosure.pdf · MANDATORY DISCLOSURE 1. Name of the Institution Name of the Institution SETHU INSTITUTE

Summer 2018 URP Resarch Project Faculty Name Email Faculty ... 2018 facult… · Summer 2018 URP Resarch Project Faculty Name Email Address Faculty College Faculty Dept Project title

Summer 2018 URP Resarch Project Faculty Name Email Faculty ... 2018 facult… · Summer 2018 URP Resarch Project Faculty Name Email Address Faculty College Faculty Dept Project title

Inspired by children Faculty Disclosure No, nothing to disclose xYes, please specify: Company Name Honoraria/ Expenses Consulting/ Advisory Board Funded.

Inspired by children Faculty Disclosure No, nothing to disclose xYes, please specify: Company Name Honoraria/ Expenses Consulting/ Advisory Board Funded.

Mandatory Disclosure Mandatory Disclosure Date · Complaints cum Redressal Committee: S.No Name of the Faculty members Department Position 1 Prof.A.Priya CSE Ombudsman 2 Dr.K.Sundaramoorthy

Mandatory Disclosure Mandatory Disclosure Date · Complaints cum Redressal Committee: S.No Name of the Faculty members Department Position 1 Prof.A.Priya CSE Ombudsman 2 Dr.K.Sundaramoorthy

CFPC CoI Templates: Slide 1 Faculty/Presenter Disclosure

CFPC CoI Templates: Slide 1 Faculty/Presenter Disclosure

108155 Public Disclosure Authorized - World Bank · 108155. Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized. No Contract Code Contract Name

108155 Public Disclosure Authorized - World Bank · 108155. Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized. No Contract Code Contract Name

The Failure of Mandated Disclosure - Chicago Law Faculty ...

The Failure of Mandated Disclosure - Chicago Law Faculty ...

McLeod Health Speakers Faculty Disclosure / Unlabeled Uses Disclosure Speakers Faculty Disclosure Unlabeled Uses Disclosure Coy Irvin, MD No relevant financial.

McLeod Health Speakers Faculty Disclosure / Unlabeled Uses Disclosure Speakers Faculty Disclosure Unlabeled Uses Disclosure Coy Irvin, MD No relevant financial.

Notice of Faculty Disclosure - ARUP Lab

Notice of Faculty Disclosure - ARUP Lab

Part 1. Faculty/Presenter Disclosure Faculty/Presenter:[insert name here] Relationships with commercial interests: Grants/research support:[insert company/organization.

Part 1. Faculty/Presenter Disclosure Faculty/Presenter:[insert name here] Relationships with commercial interests: Grants/research support:[insert company/organization.

Faculty/Presenter Disclosure

Faculty/Presenter Disclosure