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This form is to disclose potential conflicts of interest for instructors, planners, and managers involved in Continuing Medical Education (CME) activities, ensuring integrity and objectivity in educational
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How to fill out conflict of interest reporting

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How to fill out CONFLICT OF INTEREST REPORTING FORM FOR INSTRUCTORS, PLANNERS AND MANAGERS OF CONTINUING MEDICAL EDUCATION ACTIVITIES

01
Obtain a copy of the CONFLICT OF INTEREST REPORTING FORM.
02
Read the instructions provided on the form carefully.
03
List all relevant financial relationships with commercial interests related to the CME activities.
04
Include details such as the name of the organization, type of relationship, and the amount of compensation, if applicable.
05
Indicate any non-financial conflicts of interest that may impact your role.
06
Sign and date the form to verify that all information provided is accurate.
07
Submit the completed form to the appropriate authority as indicated in the instructions.

Who needs CONFLICT OF INTEREST REPORTING FORM FOR INSTRUCTORS, PLANNERS AND MANAGERS OF CONTINUING MEDICAL EDUCATION ACTIVITIES?

01
All instructors involved in the planning or execution of CME activities.
02
Planners who organize educational content for CME activities.
03
Managers overseeing the implementation of CME activities.
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I declare that: I am aware that my information is being collected for the purpose of identifying material personal interests that could influence, or could be seen to influence, the decisions that my family member takes or the advice they give as Agency Head.
Examples include: i. hiring a relative or friend as an employee or vendor, ii. buying or selling goods or services from / to a family business for which others might compete, iii. having a personal relationship where there is an immediate reporting relationship, iv.
To help identify potential conflicts of interest, the law requires public officials and employees in designated positions in a conflict of interest code to report their financial interests on a form called Statement of Economic Interests (Form 700).
A strong conflict of interest declaration describes, in as much detail as possible: the private interest, including any names, businesses, other duties and so on, and the history of the employee's relationship or affiliation to that person, company, organisation or role.
I will not solicit or accept any gift or other item of monetary value from any person or entity seeking favors from, doing business with, or conducting activities regulated by CCO, or whose interests may be substantially affected by the performance or nonperformance of my duties.
Name of party/ individual with whom I may have a direct or indirect potential relationship: Details of my relationship with the party: Type of Conflict (select which apply): Relationship of the conflicted party with the Group: Any other details:

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The CONFLICT OF INTEREST REPORTING FORM is a document used to disclose any potential conflicts of interest that instructors, planners, and managers of continuing medical education (CME) activities may have. It aims to ensure transparency and maintain the integrity of the educational activities.
Instructors, planners, and managers involved in the development and delivery of continuing medical education activities are required to file the CONFLICT OF INTEREST REPORTING FORM.
To fill out the form, individuals should provide detailed information about their financial relationships, affiliations, or interests that could be perceived as a conflict of interest related to their CME activities. This may include disclosing any relevant funding, partnerships, or personal interests.
The purpose of the form is to identify and mitigate any potential conflicts of interest in order to uphold the credibility and effectiveness of continuing medical education activities. It helps ensure that educational content is unbiased and based solely on scientific evidence.
Individuals must report their financial relationships, affiliations, ownership interests, research grants, or any other relevant personal interests that may influence their role in CME activities. This information is essential for assessing potential conflicts.
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