> IPSA 2022 Financial Disclosure
Please disclose all financial relationships that you have had in the past 24 months with "ineligible companies." An ineligible company is an entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
For each financial relationship, enter the name of the ineligible 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 ineligible companies. You should disclose all financial relationships regardless of the potential relevance of each relationship to the education.
Enter the Name of the Ineligible Company
An ineligible company is an entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
For specific examples of ineligible companies, visit accme.org/standards.
Enter the 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 below. This will help the education staff determine if any mitigation steps need to be taken.