All individuals with the ability to influence educational programming must submit a disclosure form to the ABA on an annual basis. This includes faculty, speakers, authors, moderators, committee members and others.
Please note: For Annual Meeting-related disclosures, you will be required to use the speaker management system, Cadmium, where you originally submitted the abstract, educational forum, etc.
How do I find the disclosure form?
After signing onto your profile, click on MY ACCOUNT on the left-hand panel.
Under the drop-down list, click on MY DISCLOSURE to access the disclosure form
Once you are on the ABA Disclosure Form, please fill out all the fields required below. You will need to add a new financial relationship for each relationship that you disclose. Please note: If you indicate that you have no disclosures, the field will remain empty after submitting. In addition, the field indicating your expertise also remains empty no matter.
Role in Educational Activity:
ABLS: Instructor
Content Expert
Committee Member
Regional Meeting: Planning Committee
Regional Meeting: Speaker/Course Director/Author
Course: Planning Committee
Course: Speaker/Course Director/Author
Board of Trustees
ABA Staff
None selected
Is there a financial relationship?
Companies that are ineligible to be accredited (ineligible companies) are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Eligible organizations are those whose mission and function are: (1) providing clinical services directly to patients; or (2) the education of healthcare professionals; or (3) serving as fiduciary to patients, the public, or population health; and other organizations that are not otherwise ineligible. We do not need to disclose relationships with eligible organizations.
For examples of eligible/ineligible companies, please see The Standards for Integrity and Independence in Accredited Continuing Education.
If you answer yes to all 3 items below, you’ve identified a financial relationship with an ineligible company that must be mitigated before the activity occurs.
· Financial relationship between person in control of content and an ineligible company, as defined below
· Any amount ($)
· In the past 24 months
If you answered yes, please add EACH financial relationship in your Impexium Account. If you answered no, please submit your disclosure form.
When entering your financial relationship, please:
-Add Financial Relationships - Full name of ineligible company (no initials or abbreviations, please)
Add Relationship - Check all that apply.
· Contract Research
· Employment
· Ownership Interest (Stocks or other ownership interest excluding diversified mutual funds)
· Ownership Interest (stock options, patent or other intellectual property)
· Royalties
· Speaker honoraria
· Other
None selected
Other relationships, not listed above: