Title of Lecture Series
Title of Presentation
(Speaker Name, Degree Designation)
Date
Start/End time (am/pm)
Location
Objectives:
1.
2.
3.
Disclosure
[Speaker Name], my spouse or partner, has no actual or potential conflict of interest in relation to this program
or presentation.
OR
[Speaker Name], my spouse or partner, has a financial interest/arrangement of affiliation with one or more
organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this
program and/or presentation.
OR
[Multiple Speakers] The presenters, their spouses or partners, have no actual or potential conflict of interest in
relation to this program or presentation.
All presentations have been peer reviewed to eliminate any commercial bias.
Accreditation
The Ochsner Clinic Foundation is accredited by the Accreditation Council for Continuing Medical Education to
provide continuing medical education for physicians.
Designation
The Ochsner Clinic Foundation designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.
FORM F