faculty disclosures ats – 2013 / philadelphia relevant financial relationships with a commercial...

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Faculty Disclosures Faculty Disclosures ATS – 2013 / Philadelphia ATS – 2013 / Philadelphia Relevant financial relationships with a Relevant financial relationships with a commercial interest: commercial interest: <Type your name here> < If you or your spouse/life partner, if any, DO NOT HAVE one or more financial relationships with commercial interest s that could be considered relevant to your presentation subject matter , please remove the instructions within this text box except for the following line (only): No relevant commercial interests. (Retain the above line in at least 22 point type, centered as above. ) < If you or your spouse/life partner DO HAVE one or more financial relationships with commercial interests that could be considered relevant to your presentation subject matter , please instead replace the instructions within this text box with a list of these relationships, using the format below (using at least 18 point type, a separate paragraph per company): • Company Name , followed by the Type(s) of Relationship (e.g., Research Grant) and on same line, whether that relationship is (Current) or (Past) or (Expected). See Faculty Disclosure Slide Instructions memo for detailed instructions. <

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Page 1: Faculty Disclosures ATS – 2013 / Philadelphia Relevant financial relationships with a commercial interest: Relevant financial relationships with a commercial

Faculty DisclosuresFaculty DisclosuresATS – 2013 / PhiladelphiaATS – 2013 / Philadelphia

Relevant financial relationships with a commercial interest:Relevant financial relationships with a commercial interest:

<Type your name here>

< If you or your spouse/life partner, if any, DO NOT HAVE one or more financial relationships with commercial interest s that could be considered relevant to your presentation subject matter, please remove the instructions within this text box except for the following line (only):

No relevant commercial interests.(Retain the above line in at least 22 point type, centered as above. )

< If you or your spouse/life partner DO HAVE one or more financial relationships with commercial interests that could be considered relevant to your presentation subject matter, please instead replace the instructions within this text box with a list of these relationships, using the format below (using at least 18 point type, a separate paragraph per company):

• Company Name, followed by the Type(s) of Relationship (e.g., Research Grant) and on same line, whether that relationship is (Current) or (Past) or (Expected). See Faculty Disclosure Slide Instructions memo for detailed instructions.

< Continue on additional slide(s) if needed. (See optional 3rd slide in slide set.)

Page 2: Faculty Disclosures ATS – 2013 / Philadelphia Relevant financial relationships with a commercial interest: Relevant financial relationships with a commercial

Faculty DisclosuresFaculty DisclosuresATS – 2013 / PhiladelphiaATS – 2013 / Philadelphia

““Off-label” use disclosure relevant to my presentation at Off-label” use disclosure relevant to my presentation at ATS-2013 / Philadelphia:ATS-2013 / Philadelphia:

<Type your name here>

< Please disregard this slide if you DO NOT plan to discuss any “off-label” use during your presentation. (See separate Disclosure Slide Instructions memo for more detailed instructions.)

< If you DO plan to discuss “off-label” use during your presentation, please instead replace the instructions within this text box with that disclosure, using the format below (using at least 22 point type, and a separate bulleted line per disclosure):

• Name of the Commercial Product (use generic name rather than brand name), followed by a brief description of the nature of the off-label use discussed .

< Continue on additional blank slide(s) if needed. (See optional 3rd slide in slide set.)

Page 3: Faculty Disclosures ATS – 2013 / Philadelphia Relevant financial relationships with a commercial interest: Relevant financial relationships with a commercial

Faculty DisclosuresFaculty DisclosuresATS – 2013 / PhiladelphiaATS – 2013 / Philadelphia

If an additional slide is needed, please first type the category If an additional slide is needed, please first type the category title here (i.e., either: “Relevant financial relationships with a title here (i.e., either: “Relevant financial relationships with a commercial interests’ or “Off-label use disclosure”).commercial interests’ or “Off-label use disclosure”).

<Type your name here>

< Then type your additional disclosure(s) here, using the format you used for your first slide of the same category. Use at least 18 point type.