Presenter Full Disclosure Form for CME Activities

(LA DIVULGACIÓN COMPLETA DEL PRESENTADOR PARA LAS ACTIVIDADES DE LA EDUCACIÓN MÉDICA CONTINUA)

All speakers, facilitators, instructors and presenters are required to submit a faculty disclosure form (see below) with regard to presentations at any IIRRM 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. The International Institute for Restorative Reproductive Medicine reviews the disclosure forms for any Conflict of Interest (COI) as required. All disclosures are made available to participants. If you have any questions or concerns please contact Fiona at fiona@iirrm.org.

The following form is for the RRM Live Webinar Series.

*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.