The SMSNA must insure balance, independence, objectivity, and scientific rigor in all its activities. We require all individuals in a position to influence the direction of the association to fill out the disclosure form below prior to the appointment to a leadership position within SMSNA. In order to ensure that our activities promote improvements or quality in healthcare and not a specific proprietary business interest or a commercial interest, we need to identify all conflicts of interest. Individuals are required to disclose all relevant non-SMSNA relationships, including the following:
Affiliations: Membership on the Board of Directors, holding an office, editorial position, or status as a paid employee or paid or non-paid consultant in any proprietary interest producing health goods or services, including health publishing, internet or e-commerce.
Ownership: Personal or family holdings in any commercial entity, including any publishing, internet, e-commerce or other business enterprise that provides healthcare products or services related to SMS activities.
Compensation: Support or income from commercial or other sources, including any publishing, internet or e-commerce enterprises, related to health care or to SMS activities. Income includes stock options in, royalty arrangements with, dividends from the commercial entity, honoraria for speaking engagements (exclusive of reimbursable travel costs), or in-kind payments within the past twelve months.
On May 11, 2017, the SMSNA amended its Conflict of Interest Policy to reflect a limit of $50,000 from any single commercial entity in a single year as the level at which a potential conflict of interest may exist. This policy is now effective over support received and reported in the previous full calendar year.
Declaration of a conflict of interest does not necessarily preclude serving in a leadership role within SMSNA. However, based on this disclosure information, SMSNA may disqualify any individual from planning, implementation, and participation if a conflict of interest that may contribute to commercial bias is determined to exist and cannot be resolved. Therefore, a full and honest disclosure is encouraged.
In accordance with the Conflict of Interest Policy of SMSNA, the undersigned confirms that all information below is complete and truthful.
Please fill out all fields and answer all the questions below prior to submitting this form.