• Required Speaker Information and Disclosure

    CME speakers should complete and submit all required information and disclosures before presenting. Include every question, prompt, and field shown on the source page.

  • Basic Information

  • Thank you for agreeing to speak to our members. We will need several items from you to comply with the requirements of the American Osteopathic Association for continuing medical education certification. It also helps us to ensure that your audio-visual needs are met and that the room set-up is conducive to learning. 

    In order to properly introduce you before you speak, a brief bio of 150 words or less is helpful.  AOA regulations require us to have on file a copy of your curriculum vitae as well as a statement of behavioral learning objectives. Behavioral learning objectives answer the question: “After participating in this presentation, the physician will be able to:” And then, simply states the items that the physician should be able to do. Be careful to use only action verbs (behavioral terms) in these statements – verbs such as identify, outline, prescribe, explain, differentiate, diagnose, select, palpate, measure, etc.

    Please submit three to five evidence-based source references, such as a textbook, federal rule, or journal article citation for your lecture. This is a requirement for ongoing CME accreditation. 

    Your CV should include your area of specialty, office address, educational background, professional affiliations, professional activities, publications, lectures, and most importantly, your expertise as it relates to the subject you will be discussing.

  • Format: (000) 000-0000.

  • Lecture Information

  • Will your presentation include osteopathic principles & practices (OPP)?*
  • Will your presentation include osteopathic manipulative treatment (OMT)?*

  • Disclosure

    It is the policy of the Oklahoma Osteopathic Association to ensure balance, independence, objectivity, and scientific rigor in all sponsored educational activities. In order to be in compliance with Standards for Commercial Support, the OOA has implemented a disclosure process to ensure that anyone who is in a position to influence and/or control the content of an educational activity has disclosed all real and apparent conflicts of interest (i.e., relevant financial relationships with any commercial interest).If you indicate a conflict of interest, this information will be forwarded to the Program Chair. At the start of the meeting, the Chair will remind those that have indicated a potential conflict of their responsibility to disclose any bias during the meeting that could result in a conflict of interest. In addition, please note that you must recuse yourself from involvement in any discussion where there is a potential for bias based on your financial interests. Failure or refusal to disclose or the inability to manage the identified conflict may result in our request for your withdrawal from the meeting.All persons who may impact the content of a CME activity, including faculty, planners, authors and staff, are expected to disclose to the activity audience any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of the continuing education activity. A conflict of interest exists when an individual or his/her spouse/partner has a financial relationship with a commercial interest. The ACCME defines a commercial interest as “any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests.” Relationships are defined as any financial support that pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the activity or for faculty’s presentation topic.The goal of this process is not to exclude people who have conflicts but to manage these conflicts while benefiting from your expertise. Disclosure is required so that the planning committee, activity director, and/or staff can resolve these conflicts and so that participants may be informed and forms their own judgments about the activity in the light of full disclosure of the facts. The intent of this policy is not to prevent a speaker with a potential conflict of interest from making a presentation. Furthermore, all actual and potential conflicts should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It remains for the audience to determine whether the speaker’s outside interests may reflect a possible bias in either the exposition or the conclusions presented.Explanation of Terms and Conditions: 
  • I, the undersigned (or an immediate family member or partner), have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation (NOTE: There is no need to disclose the actual financial value of any affiliation). Financial interest/arrangement is defined as being a shareholder, consultant, grant recipient, research participant, employee, and/or recipient of other financial or material support within the past 12 months.*
  • I have the following conflicts (check all that apply and provide details below)*

  • If you have conflicts: Please identify the companies and describe the nature of the conflict in the box below.

  • If you have no conflicts: Please type "I swear and attest that I have no conflicts described above." We will read this information from the podium during your introduction as required by our CME accrediting body

  • Disclosure of unlabeled/ unapproved drugs/products*

  • Release of Usage

    In consideration of the interest of the Oklahoma Osteopathic Association (OOA) to sponsor quality educational programs, I agree:
    1. 1. That I have reviewed the content of the presentation with respect to:
      a. Integrity: the information contained is accurate.
      b. Utility: the information is current and useful to its intended users.
      c. Objectivity: the information is unbiased and balanced.
      d. Copyright: the information does not violate any known copyright.

    2. That my presentation for the Educational Program of the OOA may be reprinted or reproduced in whole or in part and made available for sale by the OOA, and further, I agree

    3. That I hereby grant the OOA the right to edit and sell such educational materials for the purpose of professional development.

  • Please Indicate Your Acceptance*

  • Please upload all requested items. They are all important, either for CME provider certification or conference needs. If you have difficulty uploading your files here, please get in touch with katherine@okosteo.org to be sent a OneDrive link to do so instead.

    For CME guideline reasons, your PowerPoint presentation should not include logos or company-specific branding. If you have concerns or questions, please email katherine@okosteo.org.
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  • Select Speaker Appreciation

    Speakers may choose from the following options in appreciation recognition of their time and contribution to the OOA's CME programs:
  • Please select an option*
  • Should be Empty: