Speaker Form

Speaker Form

 

Dear NESO 2024 Annual Meeting Speaker

Thank you for your participation as a speaker or instructor in the continuing education activity, NESO Annual Meeting Hartford on November 8-9, 2024.

Why am I receiving this communication?

Northeastern Society of Orthodontists is an ADA CERP recognized provider. We appreciate your help in partnering with us to follow recognition standards and help us create high-quality education that is independent of industry influence. In order to participate as a person who will be able to control the educational content of this accredited CE activity, we ask that you disclose all financial relationships with commercial interests that you have had over the past 12 months.

ADA CERP defines a commercial interest as an entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients, or an entity that is owned or controlled by an entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

You must disclose all financial relationships, regardless of the amount, with commercial interests. We ask you to disclose regardless of whether you view the financial relationships as relevant to the education. For more information on ADA CERP Recognition Standards, please visit CCEPR.ada.org.

Why do we collect this information?

Since healthcare professionals serve as the trusted authorities when advising patients, they must protect their learning environment from industry influence to ensure they remain true to their ethical commitments. Many healthcare professionals have financial relationships with commercial interests. By identifying and mitigating relevant financial relationships, we work together to create a protected space to learn, teach, and engage in scientific discourse free from influence from organizations that may have an incentive to insert commercial bias into education.

What are the next steps in this process?

After we receive your disclosure information, we will review it to determine whether your financial relationships are relevant to the education. Please note: the identification of relevant financial relationships does not necessarily mean that you are unable to participate in the planning and implementation of this educational activity. Rather, the accreditation standards require that relevant financial relationships are mitigated before you assume your role in this activity.

To help us meet these expectations, please use the form we have provided to share all financial relationships you have had with commercial interests during the past 12 months. This information is necessary in order for us to be able to move to the next steps in planning this continuing education activity.

Sincerely,

Mariana Haughey, NESO President

 

Complete the Speaker Agreement Form (required) Complete the Speaker Financial Disclosure (required)

 

DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS

INSTRUCTIONS: As a prospective planner or faculty member, we would like to ask for your help in protecting our learning environment from commercial influence. Please complete the Financial Disclosure Form through the link above by Monday, September 2, 2024.

ADA CERP Recognition Standards requires those in a position to control the content of a CE activity to disclose any financial relationships (including those of immediate family members) with commercial interests within the last 12 months.

Northeastern Society of Orthodontists will evaluate this information for conflicts of interest and may, at its discretion, make changes to the CE activity to reduce the possibility for conflict of interest. Failure to disclose will require Northeastern Society of Orthodontists to remove you from the program and to identify a replacement for your participation.

Please disclose all financial relationships that you have had in the past 12 months with commercial interests (see definition below). For each financial relationship, enter the name of the company and the nature of the financial relationship(s). There is no minimum financial threshold; we ask that you disclose all financial relationships, regardless of the amount, with any commercial interests.

 

ADA CERP Definitions

Name of Company: Any entity which produces, markets, sells, re-sells, or distributes healthcare products used by or on patients.

Nature of Financial Relationship: Examples of financial relationships include employee, researcher, consultant, advisor, speaker, independent contractor (including contracted research), royalties or patent beneficiary, executive role, and ownership interest. Individual stocks and stock options should be disclosed; diversified mutual funds do not need to be disclosed. Research funding from ineligible companies should be disclosed by the principal or named investigator even if that individual’s institution receives the research grant and manages the funds.

Has the Relationship Ended? If the financial relationship existed during the last 24 months, but has now ended, please check the box in this column.

Commercial Interest An individual or entity that produces, markets, resells or distributes health care goods or services consumed by, or used on, patients, or (2) an individual or entity that is owned or controlled by an individual or entity that produces, markets, resells or distributes health care goods or services consumed by, or used on, patients. Providing clinical services directly to or for patients (e.g. a dental practice, dental lab, or diagnostic lab) does not, by itself, make an individual or entity a commercial interest.

Relevant Financial Relationships For a person involved in the planning, administering or presentation of a continuing dental education activity, ADA CERP considers relevant financial relationships to be financial relationships in any amount, occurring in the last 12 months, that are relevant to the content of the CE activity and that may create a conflict of interest. ADA CERP considers relevant financial relationships of the person involved in the CE activity to include financial relationships of a family member.

Conflicts of interest ADA CERP considers that a conflict of interest may exist when an individual has an opportunity to affect the content of continuing dental education activities regarding products or services of a commercial interest with which he/she has a financial relationship.