Please disclose all financial relationships that you have had in the past 24 months with ineligible companies (see definition below). 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.
By adding your initials below, you are stating "I do not have any financial relationships with any ineligible companies".
By typing your name below, you agree that you are signing this form electronically, and that your electronic signature is the legal equivalent of your manual signature. You also acknowledge that you have read and agree with the CME activity requirements.