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 Faculty Disclosure Forms

Speakers, moderators and course organizers must complete both the Conflict of Interest disclosure form and the Terms and Conditions of Engagement to participate in ASSH education programs.

Learn more about the ACCME criteria for disclosure reporting.

Disclosures Form / Conflict of Interest:  

Even if you have nothing to disclose, you must submit a COI reporting form. 

Questions?  Contact the ASSH at meetings@assh.org.

  1. Go to Member Center > My Profile > Disclosures (you will be prompted to login to access this section).
  2. Review all instructions for disclosure reporting, scroll to the end and SUBMIT.

No Disclosures to Report:

The very first question will ask if you have any relationships to disclose.  If not, indicate "no" in response, leave all other fields blank and click SUBMIT at the bottom of the form.  Once submitted, the system will timestamp your form for ASSH record keeping.

NOTE: The last three questions only need to be completed if you are applying for a position on ASSH Council or the AFSH Board. 

Financial Relationships to Disclose:

  1. The very first question will ask if you have any relationships to disclose.  If yes, indicate "yes" in response and complete the appropriate fields provided.
  2. DO NOT use abbreviations when listing corporate manufacturers. 
  3. Leave all fields where you have no relationship BLANK.
  4. Click Submit to record your response. Once submitted the system will timestamp your form for ASSH record keeping.
  5. NOTE: The last three questions only need to be completed if you are applying for a position on ASSH Council or the AFSH Board. 

At a minimum, your COI form must be updated annually.  It is your responsibility to update the form as your information changes.
 


Terms & Conditions of Engagement:

This form must be completed separately for each ASSH course or meeting you are involved in. Click here to complete the form.

Please note: You must be logged in with your ASSH username and password to access this page.

  1. Indicate the event which you participating in at the top of the page.
  2. Carefully review the information on the page and click "I agree".
  3. Complete the information required for each section.
  4. If you have an FDA disclosure, you are required to list the applicable presentation title(s), the name of the manufacturer and the drug/device in question.
  5. All presenters must agree to terms and conditions of engagement to participate as faculty at an ASSH event.
  6. If you are unable to agree to any listed term, please contact the ASSH in writing at meetings@assh.org.

For questions or assistance, contact the meetings department at meetings@assh.org or (312) 880-1900.

 

 Need Help?

 

​Contact ASSH staff

Meetings@assh.org

or call

312.880.1900

 

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