Speaker
Disclosure Form
The intent of disclosure is not to prevent a speaker with a significant financial or other relationship from making a presentation, but rather to mitigate any conflicts prior to the accredited activity so the learner may participate in a balanced, objective, and evidence-based accredited continuing education activity.
AdventHealth Tampa is accredited by the Florida Medical Association is accredited to provide continuing medical education to physicians. As a condition of this accreditation, we must adhere to the ACCME Standards for Integrity and Independence in Accredited Continuing Education. The intent of disclosure is not to prevent a speaker with a significant financial or other relationship from making a presentation, but rather to mitigate any conflicts prior to the accredited activity so the learner may participate in a balanced, objective, and evidence-based accredited continuing education activity.
If you do NOT have a Relevant Financial Relationship to disclose, please note that below and sign. If you DO have a Relevant Financial Relationship to disclose, please detail that information below and sign.
Glossary of Terms
The ACCME defines an “ineligible company” as an organization whose primary business is producing, marketing,re-selling, or distributing health care goods or services, used on, or consumed by, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests. For more information, visit accme.org.
Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected.
ACCME focuses on financial relationships with ineligible companies in the 24 months preceding the time that the individual is being asked to assume a role controlling content of the CME activity. The ACCME has not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME defines “’relevant’ financial relationships” as financial relationships in any amount occurring within the past 24 months that create a conflict of interest.
Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of an ineligible company with which he/she has a financial relationship.
Speakers/planning committee member/AdventHealth Tampa CME staff must complete and submit the disclosure statement above prior to participating in a CME activity.
Speakers/authors are required to prepare fair and balanced presentations that are objective and scientifically rigorous. All clinical recommendations must be evidence based. If a conflict of interest is disclosed prior to a presentation, the content of the presentation must be reviewed by a member of the CME committee before the actual activity takes place.
Presentations that provide information in whole or in part related to non-FDA approved uses of drugs and/or devices must clearly disclose the unlabeled indications or the investigational nature of their proposed uses to the audience.
Speakers should use scientific or generic names when referring to products in their lectures.
Speakers are not permitted to receive any direct remuneration or gifts from the commercial supporter(s) of a CME activity nor should they receive direct input from an ineligible company regarding the content of the presentation(s).