1. INSERT FACULTY PRESENTER INSERT DATE Jointly provided by Tufts University School of Medicine Office of Continuing Education and [insert institution name] INSERT PRESENTATION TITLE

2. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Tufts University School of Medicine (TUSM) and [insert institution name]. TUSM is accredited by the ACCME to provide continuing medical education for physicians. Tufts University School of Medicine designates this live activity for a maximum of [#] AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity meets the criteria of the Massachusetts Board of Registration in Medicine for [#] hour(s) of Risk Management Credit. Requirements for successful completion Participants must sign-in and attend the full activity in order to receive continuing education credits. Continuing Education Accreditation

3. Disclosures [From all faculty, course directors, planning committee, others] The following individuals have a relevant financial relationship with a commercial interest(s): RoleNameProprietary EntityNature of Financial Relationship e.g. Presenter, Course Director, Etc. The following individuals have no relevant financial relationship to report in the last 12 months with a commercial interest: [insert names of presenters, course directors, reviewers without any relevant financial relationships to report]

4. Learner Objectives At the conclusion of the session, participants will be able to: INSERT SERIES/SESSION OBJECTIVE(S)

5. Commercial Support “This activity was sponsored by an unrestricted educational grant from…” Or “This activity does not have any commercial support.”

6. Non Endorsement & TUSM OCE Policies The content and views presented in this educational activity are those of the faculty and do not necessarily reflect the opinions or recommendations of TUSM OCE. Participation in this activity does not constitute approval or endorsement of any commercial products or services. These materials have been prepared based on the best available information, but are not exhaustive of the subject matter. Participants are advised to critically appraise the information presented and encouraged to consult the available literature for any commercial products mentioned. To view the privacy policy for TUSM OCE, please see: http://medicine.tufts.edu/Education/Continuing-Education/Privacy-and-Confidentiality- Policy For further information regarding certification, please contact Tufts University School of Medicine- Office of Continuing Education at med-oce@tufts.edu or 617-636-6579 (tel.) or 617-636-0314 (fax).