Instructions for Filling Out Disclosure Slide/Form for All Presentations at ISPE Meetings

A disclosure statement must accompany each presentation. For oral presentations, potential conflicts must be listed on a disclosure slide immediately following the title slide. For poster presentations, potential conflicts must be listed on the poster after the title and in a type size consistent with the rest of the poster

The first part of the disclosure slide should list all funding sources for the current project. For a project carried out purely within a university or governmental institution with no external funding, the university or governmental institution should be named as the funding source.

On the second section of the disclaimer slide, list all other potentially conflicting relationships that existed at any time during the conduct of the study, or the 1-year period before the meeting- whichever is longer. Nonfinancial conflicts (e.g., a close relationship with, or a strong antipathy to, a person or organization whose interests may be affected) should also be disclosed, for example under "other".

List the relationships using the following categories during the conduct of the project:

• Employment by commercial entity
• Consultancies or advisory Board memberships
• Lecture fees paid by a commercial entity (honoraria)
• Expert witness for a commercial entity
• Industry-sponsored grants (received or pending) including contracted research
• Patents received or pending
• Royalties from a commercial entity
• Stock ownership or options
• Other

Only include categories for which you have a disclosure to report. Continue on a second slide, if needed.

If you have no disclosures to make, type “No relationships to disclose”.