Many healthcare professionals have financial relationships with ACCME(R) defined ineligible companies. These relationships must not be allowed to influence accredited continuing education. Financial relationships of any dollar amount are defined as relevant if the educational content is related to the business lines or products of the ineligible company. 

The Medical College of Wisconsin collects information from all planners, faculty, and others in control of educational content about all their financial relationships with ineligible companies within the prior 24 months. There is no minimum financial threshold; individuals must disclose all financial relationships, regardless of the amount, with ineligible companies. Individuals must disclose regardless of their view of the relevance of the relationship to the education. 

An ineligible company is a company whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

 
1 Start 2 Speaker Evaluation 3 Consent for Recording 4 Complete
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Please enter the Learning Objectives for this activity below. Note that an activity needs 2-3 Learning Objectives per Hour of Content.
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NOTE: If this activity is a M&M, Tumor Board, or Case Conference, you do not need to add learning objectives. Instead, please write "N/A" in the box below where learning objectives are to be entered.
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Please include a 1 paragraph bio for promotional material and speaker introduction. Example bio: Jane Smith, MD is a board-certified cardiologist with over 15 years of experience in the field. She currently serves as the Chief of Cardiology at Heart Health Hospital, where she leads a team dedicated to innovative patient care and cutting-edge research. Dr. Smith earned her medical degree from Harvard Medical School and completed her residency in Internal Medicine at Johns Hopkins Hospital. She has published numerous articles in prestigious medical journals and spoken at many national and international conferences. Her passion for advancing cardiovascular health and her commitment to patient education make her a respected leader in her field.
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In the past 24 months, have you been employed by or have ownership interest in an ineligible company (a company whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients)?
Name of your employer or company for which you have ownership interest.
As an employee or owner of an ineligible company; I attest that (check all that apply)
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Has this financial relationship ended?
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Has this financial relationship ended?
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Has this financial relationship ended?
Any additional disclosures and/or any details you can provide about how your work with the ineligible companies does or does not relate to the content of your presentation will greatly help the Office of Continuing Professional Development with the process of resolving any real or perceived conflict(s) of interest and approving your participation in content development. I will provide educational content (slides, handouts, etc) to the Medical College of Wisconsin prior to the start of the CME activity for review.
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I attest to the following: