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# and Title. Faculty Name Faculty Institution. Speaker Disclosure In the past 12 months, I have not had a significant financial interest or other relationship with the manufacturer(s) of the product(s) or provider(s) of the service(s) that will be discussed in my presentation.

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# and Title

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  1. # and Title Faculty Name Faculty Institution

  2. Speaker DisclosureIn the past 12 months, I have not had a significant financial interest or other relationship with the manufacturer(s) of the product(s) or provider(s) of the service(s) that will be discussed in my presentation. This presentation will (not) include discussion of pharmaceuticals or devices that have not been approved by the FDA or unapproved or “off-label” uses of pharmaceuticals or devices.

  3. Speaker DisclosureIn the past 12 months, I have had a significant financial interest or other relationship with the manufacturer(s) of the following product(s) or provider(s) of the following service(s) that will be discussed in my presentation. This presentation will (not) include discussion of pharmaceuticals or devices that have not been approved by the FDA or unapproved or “off-label” uses of pharmaceuticals or devices.

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