Policy Committee Meeting 12.4.23

DISCLOSURES: It is OMA’s policy to ensure balance, independence, objectivity, and scientific rigor in all continuing medical education (CME) programs. All faculty, authors, and planners are expected to disclose any real or apparent financial relationships with ineligible companies. The existence of these interests or commitments should not be viewed as decreasing the value of faculty participation. The intent of this policy is not to prevent a speaker with a potential conflict of interest from making a presentation. It is merely intended that any potential conflict should be identified openly so that listeners may form their own judgments about the presentation with the full disclosure of the facts. This information will be disclosed to participants prior to any educational activities in brief statements in all education activity materials. As a faculty member, author, and/or planner for the upcoming continuing medical education programs of the Obesity Medicine Association, an Accreditation Council for Continuing Medical Education (ACCME) accredited provider of continuing medical education, I do hereby voluntarily disclose my financial relationships with ineligible companies as defined by the ACCME. The ACCME defines a ineligible company as "those whose primary business is producing, marketing, selling, re- selling, or distributing healthcare products used by patients.” This disclosure complies with the standards for integrity and independence promulgated by the Accreditation Council for Continuing Medical Education. Do you now or have you in the past 24 months had financial interest, arrangement, or affiliation (direct or indirect payment) with an ineligible company(s) as defined in the Continuing Education Programs Faculty, Author, or Planner Policy? * No, in the past 24 months , I have not had any financial relationship with any ineligible companies . (If you answered no, move to next question) Yes, I have a real or apparent financial relationship with an ineligible company within the past 24 months . I f you answered YES to the questions above, please indicate the type of financial conflict you have in the table below

Type of Financial

Indicate Applicable

Indicate for what role you Indicate for what disease Has this relationship

Relationship WITHIN THE PAST 24 MONTHS ONLY There is no financial threshold; we ask you disclose all financial relationships. Recipient of a Salary from company in question Recipient of Royalties from company in question Recipient of Intellectual Property Rights/Patent Holder Recipient of Consulting Fees Recipient of Fees for Services Received Directly from a ineligible company or their Agents (e.g., speakers’ bureaus) Contracted Research Ownership Interest (stocks, stock options, or other ownership interest excluding diversified mutual funds) Other

Manufacturer(s)/Company serve for the identified

state/clinical area this

ended? If the financial relationship existed w/ in the last 24 months, but has now ended, please check the box in this column.

WITHIN THE PAST 24 MONTHS ONLY

Manufacturer(s)/Company financial relationship

relates to (i.e. obesity , diabetes, telemedicine,

(i.e. Speakers’ Bureau, consultant, advisory board, research, etc.)

etc.)

I attest that the above information is correct at the date of the submission:

Obesity Medicine 2024

Program: Last Name:

Initial here: