Speaker Information Center
Speaker Form
All speakers except poster presenters are required to complete and return the Biographical Data and Disclosure form and Speaker Agreement to the ASBH national office. The forms should be faxed to the national office at 847/375-6482 as soon as possible.
Biographical Data and Disclosure Form (pdf)
Complete and return the Biographical Data and Disclosure Form to the ASBH national office.
Speaker Agreement (pdf)
Complete and return the Speaker Agreement Form to the ASBH national office.
Standards for Commercial Support (pdf)
Please read and ensure your presentation complies with the standards for commercial support.
Audio/Visual
Electronic files of all presentations should be brought on a personal laptop or memory stick (also called thumb drive or jump drive). Slides cannot contain any advertising, trade names, or product group messages. If you wish to identify a facility or institution, please do so only on the introductory or concluding slide. The following standard audiovisual equipment will be provided: laptop computer (you must bring your presentation on a memory stick or bring your own laptop computer with your presentation on it), LCD projector, laser pointer, screen, and appropriate microphones. An internet connection is not included. Any sound needed for your presentation is not provided as part of the standard package. Please notify us ASAP if requesting sound for your presentation.
Registration
You must register for the meeting. You are responsible for the cost of registration as well as your own hotel and travel expenses.
Poster Presenters
Poster presenters are not required to complete the Biographical Data and Disclosure form above. Poster presenter should refer to Poster Guidelines.
Session Descriptions
4-hour Preconference Workshops: In-depth instructional sessions that allow for interaction and discussion between instructors and attendees. There will be one 15-minute scheduled break for all precons from 9:30-9:45am. You may break again at a time of your choosing for up to 15 minutes or you may make your 15-minute break a 30-minute break by breaking from 9:15-9:45am. Your break(s) may not total more than 30 minutes.
90-minute Workshop Sessions: Designed for instruction and interaction. Presenters engage and involve the members of the audience for a significant portion of the session in small group activities, breakout sessions, role play, audience feedback or discussion of cases and other content, design of materials and models, and similar forms of interactions.
60-minute Panel Sessions: A variety of perspectives are provided on a cohesive theme. An ideal panel compares and contrasts ideas of the panelists or includes presentations that build on one another.
15-minute Individual Presentations (Paper Sessions): Brief structured discussions or lectures based on a paper or work-in-progress. Only one author will present at the meeting even if the paper has several authors. The first author is the Speaker. 3-5 Individual Presentations will be grouped per time slot.
Posters: Demonstrate or explain a concept, work of art, or research project.
Speaker Agreement
All speakers except poster presenters should sign and return this speaker agreement. This form may be copied and pasted into an email or download the pdf above and return it to the ASBH national office via fax at 847/375-6482.
Terms of agreement to present at the 2008 ASBH Annual Meeting.
This correspondence constitutes the terms of agreement to present at the ASBH Annual Meeting. The following action is required:
1. Read this agreement.
2. Sign your name (typed signature is fine) at the bottom.
3. Return via email reply to Cleveland@asbh.org or fax to 847/375-6482.
Session Information
Your presentation is planned to achieve the outcomes expressed as learning objectives in your proposal. These objectives will be published in the annual meeting program book that will be provided to meeting attendees at the meeting. Your session's abstract will be published, as originally submitted, in the annual meeting program book that will be distributed to meeting attendees.
Your session as a CME Activity
Your session will be offered as a CME activity through the joint sponsorship of this meeting by the Illinois State Medical Society (ISMS). All recommendations, treatment, or manners of practicing medicine discussed in a CME activity must be within the definition of CME and must not be known (a) to have risks or dangers that outweigh the benefits or (b) to be ineffective in the treatment of patients. [ACCME Policy 2002-B-09] Please read the guidelines below that outline ASBH's requirements for clinically valid, non-biased presentations. Your signature at the bottom of this letter will indicate that you have agreed to the terms of your speaking engagement as stated here.
The Illinois State Medical Society (ISMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME). As part of our CME accreditation, which is important to us, ISMS is obligated to meet the ACCME's expectations for our practice of continuing medical education. We ask you to work with us to ensure that, together, we provide CME of the highest standard.
ISMS has implemented a process whereby financial relationships with any commercial interest by everyone who is in a position to control the content of an education activity must be disclosed to us. In order to do this, please complete the Biographical Data Disclosure Form and return it via mail or fax, 847/375-6482 by Tuesday, July 1, 2008. As per ACCME requirements, if you refuse to complete and return the form or if you refuse to disclose relevant financial relationships, we regret that we must disqualify you from being a presenter for this CME activity.
It is considered to be a conflict of interest if any faculty/author/presenter indicates that he/she has relevant financial relationships that can affect the content of the educational activity AND that have occurred within the last 12 months. These conflicts of interest must be resolved before the CME activity is delivered to the learners. If you indicate that you have a conflict of interest, in order to resolve this conflict, a detailed outline of your presentation with peer-reviewed references or best available evidence must be submitted in electronic MS Word format for review by the ISMS Committee on CME Activities by July 1, 2008. The chair of the Committee on CME Activities or his designee will review the presentation to determine if it is free of promotional, commercial and/or sales activities. If it is determined that the presentation is not free of promotional, commercial and/or sales activities, the Committee will require the ASBH Program Planning Committee to either reject the proposal or have the presenter make changes to the material. If changes are not made to ISMS's satisfaction, the proposal will be rejected.
ISMS and ASBH will be seeking feedback from the learners on the effectiveness of this CME activity through the use of a post-activity questionnaire which will ask learners about perceived bias during any presentations.
You are reminded that educational materials that are a part of this activity, such as slides, abstracts, and handouts, cannot contain any advertising, single examples of trade or brand names, or product-group messages. See Standards for Commercial Support which govern this process.
One Presentation Rule
You may participate as a speaker in a maximum of one session. Posters and preconference workshops are exempted from the one presentation rule.
Commercial Bias
All presentation and supporting materials must promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest. Generic names should be used whenever possible. If trade names are included, trade names from several companies should be used, not just trade names from a single company. See Standards for Commercial Support.
Commercial Support
You may not accept any funds from a commercial interest or medical education company for your presentation at this ASBH meeting. Please download and read the Commercial Support Form.
Content Validation
ASBH requires that all speakers comply with ACCME policy 2002-B-09, which states that: "All the recommendations involving clinical medicine in a CME activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications or contraindications in the care of patients. All scientific research referred to in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection and analysis."
Handouts
Speakers are requested to provide a handout for session attendees. Please make 100 copies of your handout before at the meeting and distribute them during your presentation. Handouts cannot contain any advertising, trade names, or product group messages. If you wish to identify a facility or institution, please do so only on the introductory or concluding page.
PowerPoint/AV
Electronic files of all presentations should be brought on a personal laptop or memory stick (also called thumb drive or jump drive). Slides cannot contain any advertising, trade names, or product group messages. If you wish to identify a facility or institution, please do so only on the introductory or concluding slide. The following standard audiovisual equipment will be provided: laptop computer (you must bring your presentation on a memory stick or bring your own laptop computer with your presentation on it), LCD projector, laser pointer, screen, and appropriate microphones.
Registration
As a speaker, you must register for the meeting. You are responsible for the cost of registration as well as your own hotel and travel expenses. A conference brochure containing a conference registration form and specific hotel and meeting information will be available in August, mailed to all ASBH members and posted on the ASBH Web site. Completing and returning the meeting registration form from the annual meeting brochure is required for registration.
Permissions
As a presenter, you acknowledge that you have obtained the appropriate copyright permission for all material that you use in your presentation.
You grant ASBH or its designated agent a non-exclusive, unrestricted, irrevocable license to record the Presentation, to prepare a transcript of the Presentation, and to reprint or otherwise reproduce, in written, video, audio or electronic format, the Presentation and/or any recording or transcript of the Presentation for the purpose of publishing and distributing for educational purposes the Presentation individually or as part of a compilation of proceedings for the benefit of ASBH or its designated agent. Such license includes the right to use your name, likeness, voice and biographical information in connection with the Presentation. You acknowledge that ASBH or its designated agent will owe you no royalty or other compensation for the Presentation or the rights granted herein. If published, ASBH will own all rights in and to the proceedings, but will have no other rights to the Presentation.
As a presenter, you agree to the best of your knowledge -
(a) The content of the Presentation is accurate;
(b) The Presentation will not violate any copyright, proprietary rights or personal rights of others;
(c) You have all necessary permissions to reproduce or use any materials for which you are not the author or copyright holder;
(d) The materials, including photographs, used in the Presentation will not identify, by name or otherwise, suggest the identity of, or present a recognizable likeness of any patient or others; or, if they do, you have all necessary consents from patients and others for the further use, distribution and publication of such materials;
(e) The Presentation will be educational in nature, will not promote any product or service, and will not contain any false or misleading statements regarding any products or services or include materials that are anticompetitive, slanderous, libelous or otherwise illegal, offensive or inappropriate; and
(f) You are authorized to make these representations.
Type your name:
End of Agreement---
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