Call for Papers - MSHA CE Events

* Presenter Name
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* Presenter Email Address
0/50
* Address and Phone Number
0/250
* Indicate which event you would like to be considered a speaker for
0/250
* Presenter (2)
0/50
Email Address
0/50
* Address
0/250
* Phone Number
0/50
* Honorarium Requested
* If you are requesting an honorarium what is the amount?
0/250
* Title of the Presentation
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* Presentation Abstract
0/500
* Each presentation must have a minimum of three course objectives/learner outcomes and your presentation must reflect these outcomes.
0/250
Speaker Bio: Please detail your bio. If your presentation is selected this bio will become available to attendees and presented at the conference.
0/500

Financial and Non-Financial Relationship Disclosure Form

For Program Planners and Instructional Personnel



In compliance with American Speech-Language Hearing Association’s Continuing Education Board’s Requirements, the Maryland Speech-Language-Hearing Association requires program planners and instructional personnel to disclose information regarding any relevant financial and non-financial relationships related to course content prior to and during course planning.  


Based on the information provided, the CE Administrator or a designated Board Member will engage the program planner/instructional personnel in a guided interview process which seeks to understand how the relevant financial or nonfinancial relationship may influence the content of the course.  

 

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* Program Planner Instructional Personnel's Name
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* Course Title
0/250
* Signature and Date
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* Financial Relationship Disclosure Form (As it relates to MSHA) Copy this page as many times as you need to complete information regarding each of your relevant financial relationships. Program Planners/Instructional personnel have a relevant financial relationship if that relationship could influence the information presented in the course and could be perceived as a conflict of interest by learners.
0/250