Template Title Speaker Name Subtitle. Disclosure Statement of Financial Interest Grant/Research...
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Transcript of Template Title Speaker Name Subtitle. Disclosure Statement of Financial Interest Grant/Research...
![Page 1: Template Title Speaker Name Subtitle. Disclosure Statement of Financial Interest Grant/Research Support Consulting Fees/Honoraria Major Stock Shareholder/Equity.](https://reader036.fdocuments.us/reader036/viewer/2022082820/56649ee15503460f94bf1e1b/html5/thumbnails/1.jpg)
TemplateTitle
Speaker Name
Subtitle
![Page 2: Template Title Speaker Name Subtitle. Disclosure Statement of Financial Interest Grant/Research Support Consulting Fees/Honoraria Major Stock Shareholder/Equity.](https://reader036.fdocuments.us/reader036/viewer/2022082820/56649ee15503460f94bf1e1b/html5/thumbnails/2.jpg)
Disclosure Statement of Financial Interest
• Grant/Research Support• Consulting Fees/Honoraria• Major Stock Shareholder/Equity• Royalty Income• Ownership/Founder• Intellectual Property Rights• Other Financial Benefit
• Company One• Company Two• Company Three• Company Four• Company Five• Company Six• Company Seven
Within the past 12 months preceding this Congress, I have had a financial interest/arrangement or affiliation with the organisation(s) listed below.
Affiliation/Financial Relationship Company
![Page 3: Template Title Speaker Name Subtitle. Disclosure Statement of Financial Interest Grant/Research Support Consulting Fees/Honoraria Major Stock Shareholder/Equity.](https://reader036.fdocuments.us/reader036/viewer/2022082820/56649ee15503460f94bf1e1b/html5/thumbnails/3.jpg)
Disclosure Statement of Financial Interest
I, (insert name) DO NOT have a financial interest/arrangement or affiliation with one or more organisations which could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.