Imuka 2009
 
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  Last update: 29 January, 2009
Imuka 2009

Conflict of Interests Statement

Stichting IMA CONFLICT OF INTERESTS DISCLOSURE STATEMENT

The Stichting IMA Disclosure Programme is intended to promote ethical and professional unbiased leadership of the Stichting IMA. All office bearers of the Stichting IMA, including the Organizing Committee and all its Sub-committees as well as all Conference Speakers are expected to complete the disclosure statement, and to update and alter this statement as circumstances change.

  1. Do you or a member of your immediate family serve on any Board of Directors, as an owner, or officer on a relevant committee of any health care organization (e.g., hospital, surgery centre, medical and/or orthopaedic professional society)?
  2. Do you or a member of your immediate family serve on the editorial or governing board of any medical and/or orthopaedic publication?
  3. Do you or a member of your immediate family receive royalties for any pharmaceutical, biomaterial or orthopaedic product or device?
  4. Within the past twelve months, have you served on the speaker’s bureau or have you been paid an honorarium to present by any pharmaceutical, biomaterial or orthopaedic product or Device Company?
  5. Are you or a member of your immediate family a paid or unpaid consultant for any pharmaceutical, biomaterial or orthopaedic device or equipment company, or supplier?
    Paid:
    Unpaid:
  6. Do you personally or, to the best of your knowledge, does your department or practice receive research or institutional support from any publisher?
  7. Do you personally or, to the best of your knowledge, does your department or practice receive research or institutional support from any pharmaceutical, biomaterial or orthopaedic device or equipment company, or supplier?
  8. Do you or a member of your immediate family own stock or stock options in any pharmaceutical, biomaterial or orthopaedic device or equipment company, or supplier (excluding mutual funds)?
  9. Do you or a member of your immediate family receive any other financial/material support from any medical and/or orthopaedic publisher?
  10. Do you or a member of your immediate family receive any other financial/material support from any pharmaceutical, biomaterial or orthopaedic device and equipment company or supplier?