Disclosure Form 2020

Conflicts of Interest (COI) | COI management | Disclosure Summary | Disclosure Slides

NOTE: Instructions for accreditation applications:

  1. Disclosures of scientific planning committee (SPC)
    Submitted to UBC CPD for review. SPC members can use either the link or the pdf.
    Link to SPC disclosure form: https://ubc.ca1.qualtrics.com/jfe/form/SV_d6WjDBVZfnm8lwx
  2. Disclosures of all others
    Submitted to the SPC for review. Includes speakers, moderators, facilitators and authors.
    PDF (fillable) disclosure form: Disclosure form 2020
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Conflicts of Interest (COI)

Below is an excerpt on how to review and manage COI, from UBC CPD Guidelines for Support Element 3: Conflict of Interest:

Element 3: Conflict of Interest (COI)

This element describes the processes and requirements for gathering, managing and disclosing conflicts of interest to participants.

3.1 All members of the SPC, speakers, moderators, facilitators and authors must provide written description of all relationships with for-profit and not-for-profit organizations over the previous two (2) years, including (but is not necessarily limited to):

  1. any direct financial payments including honoraria;
  2. membership on advisory boards or speakers’ bureaus;
  3. grants and/or awards for clinical trials or other research;
  4. patents on any drug, product or device; and
  5. all other investments or relationships that could be seen by a reasonable, well-informed participant as having potential to influence the content of the CPD activity.

Conflict of interest disclosures of all SPC members must be completed, signed and received by UBC CPD at the time of accreditation and/or certification.

COI Management

3.2 The SPC is responsible to collect and review all disclosed financial relationships of speakers, moderators, facilitators and authors in advance of the CPD activity to determine whether action is required to manage potential or real conflicts of interest. The SPC must also have procedures in place to be followed if a conflict of interest comes to its attention prior to or during the CPD activity. In many cases, ensuring that the financial relationship is fully disclosed, with description of management (how relationship is unrelated to the content), to program participants will be adequate. Otherwise, appropriate COI management strategies include:

  • The presenter is asked to present on a different subject.
  • The presenter alters their financial relationship.
  • The presenter relinquishes control of content of the presentation.
  • Independent expert content review is obtained.
  • On rare occasions, a speaker or SPC member may need to be replaced.

3.3 All members of the SPC, speakers, moderators, facilitators, authors must disclose to participants their relationships as described in sub-element 3.1. Management of potential sources of bias must also be described to participants. If no relationships exist, the statement “I have nothing to disclose” is used.

3.4 Any individual who fails to disclose their relationships as described in sub-elements 3.1 through 3.3 cannot participate as a member of the SPC, speaker, moderator, facilitator or author of an accredited and/or certified CPD activity. Disclosures are required regardless of whether or not a CPD activity has financial support.

3.5 All disclosures must be made available to participants in program materials. Speakers must additionally disclose conflicts both verbally and in writing on a slide at the beginning of a presentation. If slides will not be used disclosures must be included in written program.


      Disclosure Summary

      All disclosures must be made available to participants in program materials.

      Summary of Disclosure Statements (template)


      Disclosure Slides

      Disclosure Slides (pdf view)

      Speakers are required to disclose both written and verbal formats (slides)


      If you are unsure what to disclose, try out our award-winning UBC CPD Relationship with Industry Module and receive credits at the same time.




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