SCHOOL OF MEDICINE
OFFICE OF CONTINUING MEDICAL EDUCATION
COMMERCIAL SUPPORT AGREEMENT
Regarding Terms, Conditions, and Purposes of an Unrestricted Educational Grant
Title of CME Activity:Course Number:
Course Chair(s):
Location: / Date(s):
Name of company as you would like it to appear in course materials:
Commercial Supporter (Company Name/Branch):
Contact Person:
Address:
City: / State: / Zip:
Telephone: / Fax:
Email:
The company listed above wishes to provide an unrestricted educational grant for support for the above-named CME activity in the amount of: / $
NOTE TO PROGRAM REPS: Please remember to add your signature and date on the second page.
CONDITIONS
1.Statement of Purpose: CME is for scientific and educational purposes only and will not promote any products or services, directly or indirectly.
2.Control of Content & Selection of Presenters & Moderators: UCSF is responsible for the content and selection of presenters and moderators. Any commercial supporter, or its agents, will respond only to UCSF-initiated requests for suggestions of presenters or sources of presenters. UCSF will seek suggestions from other sources and will make the final decision on presenter(s) selected.
3.Disclosure of Financial Relationships: UCSF will disclose to the audience any significant relationships as specified by ACCME Essentials and Standards.
4.Promotional Activities: No promotional activities will be permitted in the same room as the educational activity.
5.Objectivity and Balance: UCSF will ensure that data regarding the commercial supporter’s products (or competing products) are objectively selected and presented, with favorable and unfavorable information and balanced discussion of prevailing information on the product(s) and/or alternative treatments.
6.Limitations of Data: UCSF will ensure, to the extent possible, disclosure of limitations of data, e.g., ongoing research, interim analyses, preliminary data or unsupported opinion.
7.Discussion of Unapproved Uses: UCSF requires that presenters disclose when a product under discussion is not approved for use in the United States.
8.Opportunities for Debate: UCSF will ensure opportunities for questioning or scientific debate.
9.Independence of Sponsor in the Use of Grant Funds:
a.Funds should be in the form of an educational grant made payable to “UC Regents.”
Tax ID# 94-6036493. Please mail payment to: UCSF, Office of Continuing Medical Education, Box 45368, San Francisco, CA 94155.
b.All other support associated with this CME activity (e.g., distributing brochures, preparing slides) may only be provided with the full knowledge and approval of the UCSF Office of Continuing Medical Education.
c.No other funds from the commercial supporter will be paid to the course chair, faculty, attendees or others involved with the CME activity (additional honoraria, extra social events, etc.)
The commercial supporter agrees to abide by the ACCME Standards for Commercial Support of Continuing Medical Education.
UCSF agrees to: (1) abide by the ACCME Standards for Commercial Support of Continuing Medical Education; (2) acknowledge educational support from the commercial company in program brochures, syllabi, and other course materials, and (3) upon request, furnish the commercial supporter a report concerning the expenditure of the funds provided.
AGREED:Company Representative (name):
Title:
Signature: / Date:
UCSF - CME Representative (name):
Signature: / Date:
Return this form to:
Address
City State Zip
Phone:
Fax:
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