Education Committee
Permission to Broadcast

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Speaker Name*

I. PARTICIPANT AGREEMENT: OBSERVANCE OF ISMRM/ISMRT POLICIES

Please check each box below to acknowledge that you have read and understand each statement and will satisfy all of your obligations and responsibilities as an ISMRM/ISMRT speaker.

Industry logos cannot be displayed during the presentation. Please ensure that your slides do not use a corporate logo.*

If an image of equipment must be used, and the display of a logo is unavoidable, please include multiple pieces of equipment from different manufacturers that are able to perform the same task. (If only one piece of equipment exists by one manufacturer for this purpose, then that is acceptable.)

Unlabeled Uses of Products: When an unlabeled use of a commercial product, or an investigational use not yet approved for any purpose is discussed during an educational activity, the speaker is required to disclose that the product is not labeled for the use under discussion or that the product is still investigational.*
Generic and Trade Names: Presentations must give a balanced view of therapeutic options. Use of generic names will contribute to this impartiality. If trade names must be used for clarification only, those of several companies should be used rather than only that of a single manufacturer.*
I will not accept additional compensation from any organization due to my involvement with ISMRM.*
This does not preclude a faculty member from being reimbursed for expenses by their employer. This item limits only additional funding above reimbursements.

II. VALIDATION STATEMENTS:

ISMRM supports the validation of clinical content for all accredited CE activities. Please review the following statements and indicate your intent to comply with each expectation. All recommendations for patient care in the activity, must be based on current science, evidence, and clinical reasoning, while giving a fair and balanced view of diagnostic and therapeutic options.

All scientific research referred to, reported, or used in the activity, in support or justification of patient care recommendation, must conform to the generally accepted standards of experimental design, data collection, analysis, and interpretation.*
The content will NOT advocate for unscientific approaches to diagnosis or therapy, nor promote recommendations, treatment, or manners of practicing healthcare that are determined to have risks or dangers that outweigh the benefits or are known to be ineffective in the treatment of patients.*
All published material and attributable work is appropriately cited.*

III. PERMISSION TO BROADCAST:

We need your permission in order to publish your presentation. It is REQUIRED that you select one of the options below in order to submit your contribution. Highly received content may be repurposed as a stand-alone educational activity. No presentation will be broadcast on our website without the specific permission of the author.

Permission to Broadcast*
Signature & Attestation*
By typing my full name, I attest all information provided is correct and complete and will provide any updates/changes to the status of this information, promptly.