1. To be at the very first slide at the beginning of event WELCOME (may include your dates, logo of organization, etc.) Slide 1

2. Disclosure of Commercial Support Received for the Event This program has received financial support from [organization name] in the form of [describe support here – e.g. an educational grant]. This program has received in-kind support from [organization name] in the form of [describe support here – e.g. logistical support]. Potential for conflict(s) of interest: – Organization must disclose if a supporting organization developed/licenses /distributes/benefits from the sale of a product that will be discussed in this program. Generic names are to be used. Slide 2

3. Mitigating Potential Bias Potential for conflict(s) of interest: All presenters are asked to disclose all potential conflicts at the beginning of all presentations if they have received payment/funding, gifts etc. from any organization supporting this event AND/OR organization whose product(s) are being discussed in this event. They must also disclose their participation in advisory boards, speaker bureaus, commercial organizations as well as being an investor in a commercial organization or as having participated in a clinical trial within the past 2 years. They must also disclose if they developed/licenses/distributes/benefits from the sale of a product that will be discussed at the event or if they hold a patent on a product that is marketed at the event. Generic names are to be used. All presentation are reviewed for quality assurance purposes and are cross referenced against presenter disclosure forms to ensure proper disclosure is communicated. Template: Slide 3

4. Learning Objectives of Event At the end of this event, participants will be: 1.Familiar 2.Describe 3.Explain 4.Xxx This is a sample only