In accordance with The Standards for Integrity and Independence, GW requires all planners, faculty, staff, and others in control of educational content to disclose the absence or existence of all financial relationships (of any dollar amount) with any ineligible companies within the past 24 months.  

Ineligible Companies Definition: We define ineligible companies as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. 

Disclosure statements are reviewed to determine which financial relationships are relevant to the educational content of the accredited CE Activity.  An individual is considered to have a relevant financial relationship if the educational content an individual can control is related to the business lines or products of the ineligible company. All relevant financial relationships are mitigated to prevent commercial bias and are disclosed to learners prior to the activity.  Any individuals who refuse to provide this information will be disqualified from all involvement in the planning and implementation of the accredited CE activity. 

 

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Content Validity

All speakers, presenters, authors, and writers are expected to identify in their educational content any new and evolving topics for which there is a lower (or absent) evidence base. This includes the discussion of (1) off label/unapproved or investigational uses of FDA approved commercial products or devices and/or (2) products or devices not yet approved in the United States.

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Disclosure of Financial Relationships
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Instructions

  • For each financial relationship:
    • Enter the name of the ineligible company (Examples of Ineligible Companies)
    • Select the nature of the financial relationship(s) (Examples of Financial Relationships)
    • Indicate if the financial relationship has ended. 
    • Indicate if the ineligible company has business lines or products related to the content of this CE activity or your individual presentation(s).

Guidance

  • Individual stocks and stock options should be disclosed. 
  • Diversified mutual funds do not need to be disclosed. 
  • Research funding from ineligible companies should be disclosed by the principal or named investigator even if that individual’s institution receives the research grant and manages the funds. 
  • There is no minimum financial threshold; we ask that you disclose all financial relationships, regardless of the amount, with ineligible companies. 
  • You should disclose all financial relationships regardless of the potential relevance of each relationship to the accredited CE activity.
  • You may add as many financial relationships as necessary.
Any relationship in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria for promotional speakers’ bureau, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.
If the financial relationship existed during the last 24 months, but has now ended, please select yes.
Any relationship in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria for promotional speakers’ bureau, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.
If the financial relationship existed during the last 24 months, but has now ended, please select yes.
Any relationship in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria for promotional speakers’ bureau, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.
If the financial relationship existed during the last 24 months, but has now ended, please select yes.
Any relationship in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria for promotional speakers’ bureau, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.
If the financial relationship existed during the last 24 months, but has now ended, please select yes.
Any relationship in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria for promotional speakers’ bureau, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.
If the financial relationship existed during the last 24 months, but has now ended, please select yes.

 

Attestation 

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I attest that the above information is correct as of this date of submission.
I understand that this information will be reviewed to determine whether a conflict of interest may exist, and this information will be provided to participants.
I understand that failure or refusal to disclose, false disclosure, or inability to resolve conflicts of interest will require the Office of CEHP to find a substitute planner/presenter.
I understand that if I enter a new financial relationship between the time, I complete this form and the educational activity, it is my responsibility to notify CEHP prior to the activity.