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Faculty Disclosure Slide Templates

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1 Faculty Disclosure Slide Templates
Please note: for the ATS 2018 International Conference, the following Faculty Disclosure Slide templates are only intended for use by presenters of Sunrise, Meet the Professor, Medical Education and Faculty Development Seminars and Thematic Seminar Series, who must bring their presentations on a flash drive to their meeting room. Each presenter in the sessions above sessions must display their disclosure slide(s) at the start of their presentation to comply with accreditation requirements.

2 Faculty Disclosures Type your name here If you or your spouse/life partner, if any, HAVE NOT HAD A FINANCIAL RELATIONSHIP WITH A RELEVANT COMMERCIAL INTEREST (i.e., with a commercial interest such as a pharmaceutical or medical device manufacturer that could be considered relevant to your presentation) WITHIN THE PAST 12 MONTHS, or EXPECT TO BY END OF 2018, please state the above, in at least 20 point type: No financial relationships with a relevant commercial interest. If you or your spouse/life partner, if any, HAVE HAD A FINANCIAL RELATIONSHIP WITH A RELEVANT COMMERCIAL INTEREST WITHIN THE PAST 12 MONTHS, OR EXPECT TO BY END OF 2018, state it as below. If involved with more than one relevant company, type using a separate bulleted entry for each. Use the optional blank slide in this set if needed. Financial relationships with a relevant commercial interest: The company name (or the relevant Intellectual Property of yours if not yet sold or licensed to a particular company) , followed by the type of relationship(s) with that company, e.g., Research Support, Consultant, Advisory Committee, followed by, within parentheses, whether (Exists now or expected) or (Ended within the past year). See separate instructions memo for other types of relationships.

3 Faculty Disclosures u Type your name here “Off-label” use discussed within my presentation: Do not use this slide if YOU WILL NOT discuss within your presentation any “off-label” use (i.e., use of product that has not yet been approved by the U.S. Food and Drug Administration for the use presented, or investigational use of a drug or device that has not yet been approved by the U.S. Food and Drug Administration). If YOU WILL discuss “off-label” use during your presentation, please instead replace these instructions with the following information and format, using at least 20 point type. If you will discuss more than one “off-label use” within your presentation, type a separate bulleted line or paragraph for each. Name of the commercial product (use the generic name rather than brand name), followed by a brief description of the nature of the off-label use discussed. If you need additional space, use the optional 3rd slide in this slide set.

4 Faculty Disclosures u Type your name here Use this optional extra slide template if an additional slide is needed. Please first type the category title as shown in previous slides (i.e., either Financial relationships with commercial interests or Off-label use discussed within my presentation). Then type your additional disclosure(s) here, using the same format you used for your first slide of the same category. Use at least 20 point type.


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