12.18.23 OMA Board Book

2024 OMA Corporate Partner Application (web-based) Questionnaire https://obesitymedicine.org/about/corporate-partnerships/new-advertisers exhibitors-and-sponsors/ Contact Information Company Name Company Type (Choices include: Lifestyle & Behavior, Measurement Device and Metabolic Testing, Nutrition/Supplements, Pharmaceutical, Physical Activity/Exercise, Services, Technology Hardware/Software, Esthetics/Appearance, Other) Address (City, State, Zip Code) Website Primary Contact Name Primary Contact Phone Primary Contact E-mail How would you like to partner with the OMA? (Choices include: Exhibits, Advertising, Sponsorships or Other; respondents can multiselect their choices) Does your advertised product or service require FDA approval? (Choices include: Yes, No, or Not Applicable) Has your advertised product or service obtained FDA approval? (Choices include: Yes, No, or Not Applicable) Does your company sell human chorionic gonadotropin (HCG), compounded Semaglutide, compounded Tirzepatide, compounded Retatrutide, or other compounded peptides for weight loss? (Choices include: Yes, No, or Not Applicable) Does your company plan to market a franchise? (Choices include: Yes, No, or Not Applicable) Describe your product or service: (Free text box) Describe how your product or service might help patients with obesity. Please be specific. (Free text box) Upload a recent sample of your company’s marketing materials (e.g. website, brochures, flyers, postcards, news/research article, etc.) Have your received prior exhibitor or marketing approval from the OMA in the past? (Choices include: Yes or No) By submitting this form, you acknowledge reading and agreeing to the OMA’s Exhibitor Rules and Regulations and Antitrust Guidelines. Additional information will be required to exhibit, sponsor, or advertise and approval is not guaranteed.

Commented [TF1]: Strengthened this language.