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DISCLOSURE FORM Regular Scheduled Series Single Activity Courseware (print): Phone Number: Title: Email: Indicate Role in CME Activity Speaker/Presenter Moderator Planner/Planning Committee Member

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How to fill out faculty disclosure agreement form

01

Obtain a copy of the faculty disclosure agreement form from the relevant department or office.

02

Fill in your personal information, including your name, contact information, and position/title.

03

Disclose any relevant financial interests or relationships that may present a conflict of interest.

04

Sign and date the form to certify the accuracy and completeness of the information provided.

05

Submit the completed form to the designated individual or office as per the instructions provided.

Who needs faculty disclosure agreement form?

01

Faculty members

02

Researchers

03

Educators

04

Administrators

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What is faculty disclosure agreement form?

The faculty disclosure agreement form is a document where faculty members report any potential conflicts of interest or commitment.

Who is required to file faculty disclosure agreement form?

All faculty members are required to file the faculty disclosure agreement form.

How to fill out faculty disclosure agreement form?

Faculty members can fill out the form by providing detailed information about any potential conflicts of interest or commitment.

What is the purpose of faculty disclosure agreement form?

The purpose of the faculty disclosure agreement form is to ensure transparency and integrity in academic and research activities.

What information must be reported on faculty disclosure agreement form?

Faculty members must report any financial interests, affiliations, or activities that could potentially bias their research or decision-making.

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