Forms & Tools to Support the New Standards

Download the files in this section to update your forms and templates and to assist you with the identification, mitigation, and disclosure of financial relationships.

1. Continuing Education Disclosure Form (2021)
2. Identification and Mitigation Tool (2021)
3. Disclosure Tip Sheet (2021)
4. Flowchart for Financial Relationships (2017) Updated version coming soon!
5. Commercial Support Agreement (2021)
6. In-kind Support Agreement (2021)
7. Exhibitor Agreement (2021)

If you will not use the CE Portal to collect disclosures, an updated online disclosure form is available here: Global Disclosure (version 2021).

Sample Disclosure of Financial Relationships to Learners

Note that when relationships are disclosed, a mitigation statement must follow the disclosure: “All of the relevant financial relationships listed for these individuals have been mitigated.”

►If no-one has any relationships (or the activity is non-clinical):

“None of the planners [,faculty, reviewers, authors, moderators, etc] for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.”

►If only one or two people have relationships:

“Nicolas Garcia, faculty for this educational event, is a consultant for XYZ Device Company. Dr. Yvonne Gbeho, planner for this educational event, has received a research grant from ABC Pharmaceuticals.
All of the relevant financial relationships listed for these individuals have been mitigated.
All others in control of content have no relevant financial relationships with ineligible companies.”

►If several people have relationships:

“The following individuals have disclosed relevant financial relationships with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients:

List (1) the name of each individual, (2) the name of the ineligible company, and (3) the nature of the relationship(s).

All of the relevant financial relationships listed for these individuals have been mitigated. All others in control of content have no relevant financial relationships with ineligible companies.”

Sample Disclosure of Commercial Support to Learners

"UCSF gratefully acknowledges the support of the following companies for this educational activity:" followed by a list of each supporting company.

Do not include any company logos, trademarks, or product messaging in your disclosure. For companies that donated goods or services in-kind, also identify the products or services provided followed by "(in-kind)".

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