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Published byEskild Borgen Modified over 5 years ago
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Use the following slide to disclose any conflicts of interest
Form 1-A: For oral presentation at the annual meeting with no conflicts of interest to declare. Japan Society for Hematopoietic Cell Transplantation COI disclosure Name of first author : e.g., John Doe I have no personal or financial interests to declare: I have no financial support from an industry source at the current presentation.
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Form 1-B: For oral presentation at the annual meeting、with conflict of interest to declare.
Japan Society for Hematopoietic Cell Transplantation COI disclosure Name of first author : e.g., John Doe I currently have, or I have had in the past two years, an affiliation or financial interest with business corporation(s): (Yes or No, if “yes” include name of company) (1) Consulting fees: No (2) Stock / allotment: No (3) Patent royalties / licensing fees: No (4) Honoraria (e.g. lecture fees): No (5) Fees for promotional materials: No (6) Research funding: Yes, Company X (7) Scholarship from corporation: Yes, Company Y (8) Corporate laboratory funding: Yes, Company Z (9) Others (e.g. trips, travel, or gifts) No
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Use the following to disclose your conflict of interest for a poster presentation at the annual meeting. Form 1-C: Disclosure of conflict of interest As first author, I have no personal or financial interests to declare: I have no financial support from an industry source at the current presentation. OR COI disclosure of first author (1) Consulting fees: No (2) Stock / allotment: No (3) Patent royalties / licensing fees: No (4) Honoraria (e.g. lecture fees): No (5) Fees for promotional materials: No (6) Research funding: Yes, Company X (7) Scholarship from corporation: Yes, Company Y (8) Corporate laboratory funding: Yes, Company Z (9) Others (e.g. trips, travel, or gifts) No
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