Resolution Stock Options

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					                                            Wake AHEC
                             Resolution of Conflicts of Personal Interest

Wake AHEC adheres to the Standards for Commercial Support of the Accreditation Council for
Continuing Education (ACCME), North Carolina Nurses Association (NCNA) and American
Nurses Credentialing Center’s Commission on Accreditation (ANCCOA), Accreditation Council
on Pharmacy Education (ACPE), Academy of General Dentistry (AGD), and Allied and Mental
Health accreditation bodies as appropriate which stipulate, in part, the following:

STANDARD 2: Resolution of Personal Conflicts of Interest
2.1    The provider must be able to show that everyone who is in a position to control the content of an education
       activity has disclosed all relevant financial relationships with any commercial interest to the provider.
       “Relevant financial relationships” are defined as financial relationships in any amount occurring within the
       past 12 months that create a conflict of interest. These may include relationships in which the individual
       benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership
       interest (e.g. stocks, stock options, or other ownership interest, excluding diversified mutual funds), or other
       financial benefit. Financial relationships can also include “contracted research” where the institution gets the
       grant and manages the funds and the individual is the principal or named investigator on the grant.
       Financial benefits are usually associated with roles such as employment, management position,
       independent contractor (including contracted research), consulting, speaking and teaching, membership on
       advisory committees or review panels, board membership, and other activities from which remuneration is
       received, or expected.
2.2    An individual who refuses to disclose relevant financial relationships will be disqualified from being a
       planning committee member, a teacher, or an author of continuing education, and cannot have control of, or
       responsibility for, the development, management, presentation or evaluation of the continuing education
2.3    The provider must have implemented a mechanism to identify and resolve all conflicts of interest prior to the
       education activity being delivered to learners.

In order to meet the above standards, all CME programs of Wake AHEC require all
individuals with financial relationships to sign they agree to the following:

“I acknowledge that I have read Standard 2 above of the Wake AHEC Resolution of Personal
Conflicts of Interest and hereby attest that the relationship(s) with commercial interests I have
duly disclosed will not influence or bias my presentation and/or planning of the continuing
education activity. I will adhere to the principle that information presented to the learner must be
unbiased, scientifically balanced, and based on best evidence and best practices as currently
understood. I will disclose any limitations of data and/or any discussion of off-label,
experimental, and/or investigational use of drugs or devices in my presentation.”

Individual’s Name:
(Your name and credentials as applicable)

Relationship to the Activity:
(e.g. Speaker, Course Director, Series Coordinator, Author, Planning Committee Member)

Signature                                                                        Date

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