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This document is a disclosure form for speakers or panelists participating in the FDA workshop regarding the risks and benefits of long-term nicotine replacement therapy products. It requests information
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How to fill out FDA Public Workshop Speaker or Panelist Disclosure Form

01
Begin by downloading the FDA Public Workshop Speaker or Panelist Disclosure Form from the FDA website.
02
Fill in your full name and contact information in the designated sections.
03
Indicate your professional affiliations and any relevant positions held that may relate to the workshop.
04
Disclose any financial relationships or conflicts of interest with organizations that may be affected by the workshop topics.
05
Provide details of any funding or sponsorships received related to work in the relevant area.
06
Review your form for accuracy and completeness before submission.
07
Submit the completed form via the specified method outlined by the FDA, ensuring it is submitted by the deadline.

Who needs FDA Public Workshop Speaker or Panelist Disclosure Form?

01
Any individual who is invited to speak or serve as a panelist at an FDA Public Workshop.
02
Speakers and panelists who have financial interests or affiliations that could potentially influence their presentations.
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The FDA Public Workshop Speaker or Panelist Disclosure Form is a document that requires speakers or panelists involved in FDA public workshops to disclose their financial relationships and affiliations that could potentially influence their presentations or discussions.
Speakers and panelists who participate in FDA public workshops are required to file the FDA Public Workshop Speaker or Panelist Disclosure Form.
To fill out the FDA Public Workshop Speaker or Panelist Disclosure Form, individuals should provide their personal information, detail their financial relationships and affiliations that are relevant to the workshop topics, and sign the form to certify that the information disclosed is accurate.
The purpose of the FDA Public Workshop Speaker or Panelist Disclosure Form is to ensure transparency, mitigate potential conflicts of interest, and maintain the integrity of the information presented at FDA workshops.
The form must report information regarding any financial relationships, including funding sources, sponsorships, and affiliations with commercial entities that could influence the speaker's or panelist's views or recommendations during the workshop.
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