Instructions

TeleSpecialists Learning Center requires that conference content, faculty presentations, discussions and educational materials comply with the appropriate standards and must ensure balance, independence, objectivity, and scientific rigor in all its individually sponsored education activities. This document must be completed by all individuals who have influence over the content of the educational activity. Persons who fail to complete this form are not eligible to be involved as a presenter/planner.

1. Add Activity Information

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Click on the calendar icon to select a date.

 

2. Review Financial Disclosure

Enter the financial relationship below.  Add as many as necessary to list all relationships.

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Financial Relationships
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3. Complete Declaration

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Glossary

Ineligible companies

Companies that are ineligible to be accredited in the ACCME System (ineligible companies) are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Examples of such organizations include:
  • Advertising, marketing, or communication firms whose clients are ineligible companies
  • Bio-medical startups that have begun a governmental regulatory approval process
  • Compounding pharmacies that manufacture proprietary compounds
  • Device manufacturers or distributors
  • Diagnostic labs that sell proprietary products
  • Growers, distributors, manufacturers or sellers of medical foods and dietary supplements
  • Manufacturers of health-related wearable products
  • Pharmaceutical companies or distributors
  • Pharmacy benefit managers
  • Reagent manufacturers or sellers

For more information, visit www.accme.org.

Financial relationships
Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected.
Relevant financial relationships
ACCME focuses on financial relationships with ineligible companies in the 24-month period preceding the time that the individual is being asked to assume a role controlling content of the activity. ACCME has not set a minimum dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship.
Conflict of Interest
Circumstances create a conflict of interest when an individual has an opportunity to affect educational content about products or services of a commercial interest with which he/she has a financial relationship.