My Abstract Submissions

My Author Disclosure Submissions

TITLE OF ABSTRACT:WisdmLabs Demo

AUTHOR NAME:

Demo WisdmLabs

AUTHOR NAME:

Demo WisdmLabs

TITLE OF ABSTRACT:

WisdmLabs Demo

Please complete

PLEASE COMPLETE ALL SECTIONS AND SIGN BELOW

Affiliations, if any:

I have/had an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization. Complete the section below as it applies to you during the past two calendar years. Please indicate the commercial organization(s) with which you have/had affiliations, and briefly explain what connection you have/had with the organization. You must disclose this information to your audience

I have/had an affiliation

Complete the section below as it applies to you during the past two calendar years. Please indicate the commercial organization(s) with which you have/had affiliations, and briefly explain what connection you have/had with the organization. You must disclose this information to your audience

I DO NOT have an affiliation

Speakers who have no involvement with industry should inform the audience that they cannot identify any conflict of interest.

Affliation(s)

A: I am a member of an Advisory Board or equivalent with a commercial organization.

No

B: I am a member of a Speakers bureau.

No

C: I have received payment from a commercial organization. (including gifts or other consideration or ‘in kind’ compensation)

No

D: I have received a grant(s) or an honorarium from a commercial organization

No

DISCLOSURE/CONFLICT OF INTEREST DECLARATION

Acknowledgment:

I acknowledge that the above information is accurate and I understand that this information will be publicly available.

Signature

Entry Date

June 29, 2018