Sample Slide Format for COI Disclosure at Academic Meetings

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This presentation provides a sample slide format for disclosing conflicts of interest (COI) at academic meetings. It includes guidelines for using Form 1-A when no conflicts exist and for using Form 1-A when conflicts need to be disclosed. The format also covers details about financial interests and affiliations that should be included in the COI disclosure slide. At the end of the presentation, the slide for conclusions must be used.


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  1. Title First Name, Middle Initials and Surname Affiliation

  2. Please use the sample slide format to disclose COI status Use Form 1-A when there are no conflicts of interest to disclose when giving a presentation at an academic meeting The Japanese Circulation Society COI Disclosure Name of Authors : The authors have no financial conflicts of interest to disclose concerning the presentation.

  3. when there are no conflicts of interest to disclose when giving a presentation at an academic meeting Please use the sample slide format to disclose COI status Use Form 1-A The Japanese Circulation Society COI Disclosure Name of Authors : Use Form 1-A when you have conflicts of interest to disclose concerning a presentation. Give the name of commercial entity involved. Consultation fees: none stock ownership/profit: none patent fees: none remuneration for lecture: none manuscript fees: pharmaceutical company trust research/joint research funds: pharmaceutical company scholarship fund: pharmaceutical company Affiliation with Endowed Department: yes pharmaceuticals Other remuneration such as gifts: none

  4. Conclusions A the end of presentation, Please make sure to use this slide

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