As a planning committee member, you are involved in making decisions about this educational activity's agenda, speakers, objectives, and exhibitors. You are attesting that these decisions are being made free of commercial bias.

Before completing this form, consider: Do you have any financial relationships with companies that could benefit from the content or recommendations in this educational activity?

Ineligible companies are entities whose primary business is producing, marketing, selling, re-selling or distributing healthcare products or services used by or on patients. Examples include pharmaceutical companies, medical device manufacturers, and healthcare technology companies.

Do NOT include: Government grants (NIH, NSF, CDC, etc.), non-profit organizations, insurance companies, or your own medical practice/employer.

If you have relevant relationships with ineligible companies, select "No" and explain your concerns in the text box. If you have no relevant relationships, select "Yes" to attest the committee's decisions are free of bias.