Author Disclosure of Relevant Financial Relationships
Northern California Chapter of the American College of Surgeons
In accordance with ACCME regulations (ACCME Standard 3), the American College of Surgeons must ensure that anyone who is in a position to control the content of the education activity has disclosed to us all financial relationships with any ineligible companies in the 24 months prior to their involvement in the educational activity. There is no minimum financial threshold; we ask that you disclose all financial relationships, regardless of the amount, with ineligible companies. You should disclose all financial relationships regaurdless of the potential relevance of each relationship to this education.
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Ineligible Company: Companies that are ineligible to be accredited in the ACCME system (ineligible companies) are those whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.
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| Financial Relationships: Financial relationships are relevant if the following three conditions are met for the individual who will control content of the education: 1) a financial relationship, in any amount, exists between the person in control of content and an ineligible company; 2) the financial relationship existed in the last 24 months; 3) the content of the education is related to the products of an ineligible company with whom the person has a financial relationship. |
| Has the Financial Relationship Ended? If the financial relationship has existed during the last 24 months, but has now ended, please check the box in this column. This will help the education staff determine if any mitigation steps need to be taken. |
All CME Planners and Speakers/Moderatlors/Disscussants/Autors/Editors etc. involved in the development and/or presentation of CME content must complete this form. This form must be updated whenever circumstances require. As relevant, all disclosure information for speakers must be revealed by a slide at the beginning og the presentation.