As an individual participating in developing the content of the OpenAnesthesia CME activity, please review the definitions and complete the affirmation below. Disclosure of relevant financial relationships with commercial interests must be completed by all individuals in a position to control the content of a CME activity.

Conflict of Interest: A conflict of interest is created when an individual has an opportunity to affect CME content about products or services of a commercial interest with which the individual (or the individual’s spouse/partner) has a financial relationship.

Commercial Interest: Any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients. Providers of clinical services directly to patients are not considered to be commercial interests.

Financial Relationships: Relationships in which the individual (or spouse/partner) benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.


I (and my spouse/partner) currently do not have, and have not had within the past 12 months, any financial relationships with a commercial interest that produces, markets, resells, or distributes healthcare goods or services consumed by, or used on, patients.

I understand that CME guidelines prohibit me from accepting any reimbursement (financial, gifts, or in-kind exchange) relative to my work on OpenAnesthesia from any source other than OA/IARS.

☐ I confirm that the above statement is true and correct. I will notify OA within 30 days if there are any changes to this affirmation.