様式１AB （Form4－Ａ）　If there is no state of conflict of interest requiring disclosure The Japanese Society of Neurology (JSN) ＣＯＩ Disclosure 　 Name of Lead.

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Presentation transcript:

様式１AB （Form4－Ａ）　If there is no state of conflict of interest requiring disclosure The Japanese Society of Neurology (JSN) ＣＯＩ Disclosure 　 Name of Lead Presenter：　○○○○ There are no companies, etc. in a relation of conflict of interest requiring disclosure in relation to the presentation.

様式１AB （Form4－B）　If there is a state of conflict of interest requiring disclosure The Japanese Society of Neurology (JSN) ＣＯＩ Disclosure 　 Name of Lead Presenter：　○○○○ Companies, etc. in a relation of conflict of interest requiring disclosure in relation to the presentation:　　　　　　　　　　　(*Indicate "None" if not applicable.) 　①Advisor: 　　　　　　　　　 ○○ Pharmaceutical Industries 　②Stock ownership/capital gain: ○○ Pharmaceuticals 　③Patent royalties: 　　　　　　　 ○○ Pharmaceutical Industries 　④Honoraria: 　　　　　　　　　 ○○ Pharmaceuticals 　⑤Writing fees: 　　　　　　　　　　 ○○ Pharmaceutical Industries 　⑥Grants for commissioned/joint research: ○○ Pharmaceutical 　⑦Scholarship grants: 　　　　 ○○ Pharmaceuticals 　⑧Endowed chair: ○○ Pharmaceutical 　⑨Gifts or other forms of compensation: ○○ Pharmaceutical Industries