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Faculty/Presenter Disclosure - PowerPoint PPT Presentation


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CFPC CoI Templates: Slide 1. Faculty/Presenter Disclosure. Faculty: [Speaker’s name] Relationships with commercial interests: Grants/Research Support: PharmaCorp ABC Speakers Bureau/Honoraria: XYZ Biopharmaceuticals Ltd. Consulting Fees: MedX Group Inc.

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faculty presenter disclosure
CFPC CoI Templates: Slide 1Faculty/Presenter Disclosure
  • Faculty: [Speaker’s name]
  • Relationships with commercial interests:
    • Grants/Research Support: PharmaCorp ABC
    • Speakers Bureau/Honoraria: XYZ Biopharmaceuticals Ltd.
    • Consulting Fees: MedX Group Inc.
    • Other: Employee of XXY Hospital Group
disclosure of commercial support
CFPC CoI Templates: Slide 2Disclosure of Commercial Support
  • This program has received financial support from [organization name]in the form of [describe support here – e.g. an educational grant].
  • This program has received in-kind support from [organization name]in the form of [describe support here – e.g. logistical support].
  • Potential for conflict(s) of interest:
    • [Speaker/Faculty name] has received [payment/funding, etc.] from [organization supporting this program AND/OR organization whose product(s) are being discussed in this program].
    • [Supporting organization name] [developed/licenses/distributes/benefits from the sale of, etc.] a product that will be discussed in this program: [insert generic and brand name here].
mitigating potential bias
CFPC CoI Templates: Slide 3Mitigating Potential Bias
  • [Explain how potential sources of bias identified in slides 1 and 2 have been mitigated].
  • Refer to “Quick Tips” document
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