CME Activity Conflict of Interest Disclosure by Pride in Practice · February 23, 2020 Pride in Practice complies with the Standards for Commercial Support of the Accreditation Council for Continuing Medical Education (ACCME). Employees, founders, or principals of commercial interests are not permitted to present material for CME credit when the topic of their presentation is related to the business lines of their companies. A "commercial interest" is any entity that is testing, producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients, excluding providers of clinical services (i.e., hospitals, medical groups, etc.). If you will discuss products or services in your presentation that are produced by a commercial interest with which you, your spouse, or your partner have had a financial relationship over the past 12 months, you must disclose that relevant financial relationship. The presence of a conflict of interest does NOT necessarily disqualify you from participation, but you must disclose the conflict to us and to the activity's participants. You must also follow our instructions to resolve/manage your conflict of interest.Please enable JavaScript in your browser to complete this form.General Information and Your Role(s) in the CME ActivityName *FirstLastEmail *Activity Title *Activity Date(s) *Title of Your Presentation(s) and/or Topic(s) *Your Role(s) (Check all that apply) *Activity DirectorAuthorFaculty/PresenterModeratorReviewerPlanning CommitteePlease Disclose Any Relevant Financial Relationships For This CME ActivityAre you an employee or founding/principal member of a company that is testing, producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients? [Companies or organizations that provide clinical services - such as HCOs, physicians' groups or radiologic clinics - are EXEMPTED.] *YesNoDo you receive currently, or have you received in the past 12 months, payment from a company for any of the following or similar work you provided: speakers' bureau, consultant, grant/research support, etc.] *YesNoIn this CME presentation, will you discuss any products or services that were developed by a commercial interest (e.g., pharmaceutical company or device manufacturer) with which, within the past 12 months, you, your spouse, or your partner have had a financial relationship? [Check "Yes" ONLY if all conditions of the preceding sentence apply.] *YesNoPlease list the commercial interest(s) and define your relationship(s) (e.g., founder, chief medical officer, speakers' bureau, consultant, research support, stockholder, royalties, or similar). *List one interest and relationship per line.Your AttestationRegardless of any relevant financial relationships disclosed above, I attest that the content for this activity will provide a well-balanced, evidence-based, and unbiased approach to diagnostic and therapeutic options related to quality patient care.Your Signature *Date of Signature *WebsiteSubmit