Presenter Full Disclosure

Form for CME Activities

All speakers, facilitators, instructors and presenters are required to submit a faculty disclosure form (see below) with regard to presentations at any IIRRM-A hosted conference, in accordance with requirements for CME accreditation. Disclosure must be made to the audience indicating whether you have or have not had relationships with for‐profit or not‐for‐profit organizations within the past 2 years.

In additional all speakers/faculty must disclose to IIRRM and learners when an unlabeled use of a commercial product, or an investigational use not yet approved for any purpose, is discussed during an educational activity. Speakers/Faculty must disclose that the product is not labeled for the use under discussion or that the product is still investigational. The intent of this policy is not to prohibit or limit the exchange of views in scientific and educational discussions, including discussions of unapproved uses, but to ensure that faculty discloses to learners that such discussion will take place.

The conference planning committee reviews the disclosure forms for any Conflict of Interest (COI). All disclosures are made available to participants.  IIRRM's full policy and procedures for managing conflicts of interest can be viewed here. If you have any questions or concerns please contact Kathleen at kathleen@iirrm.org.

The following form is for virtual presentation at the North American Regional Conference for Restorative Reproductive Medicine being held on July 22, 2020 .

*This will be listed in the conference program

(A commercial interest is any entity producing, marketing, re-selling, or distributing health care goods or services. This includes online services, programs and material)

* Please identify to the audience at the start of your presentation the unapproved or investigational product or device. This can also be done on the second slide of your presentation.