Conflict of Interest and Financial Disclosures Declaration

All participants involved in the delivery of conference content are strongly encouraged to review and complete this form.
Presenters- both submission of this form, and a visual/verbal disclosure in your talk are expected as best practices.
Questions? Email: scientific@cann.ca

Name and Contact Info

Personal Information and Conference Role

First Name and Last name *(Up to 8 Words)

Conference Role * (Minimum 1, Up to 6 selections)

This is a multi-select option, select all that apply

Please provide the best email to reach you:*

Check this box to receive submission confirmation

Confirm Please provide the best email to reach you:*

Please provide the best phone number to reach you*(Up to 5 Words)

Conflict of Interest (COI) Declaration- Select ONE statement:* (Minimum 1, Up to 1 selections)

If selecting No Conflicts proceed to Signature and Date fields

If selecting HAVE conflicts proceed through the remainder of the form

I have NO real or potential conflicts of interest to disclose

I HAVE real or potential conflicts of interest to disclose

Content‑Related Disclosures (For Presenters/Authors Only)

Session/Presentation Title(s)(Up to 100 Words)

Please enter the title of the sessions you are involved in delivering at this event

Will you discuss or recommend medications, devices, or interventions that are not approved (“off‑label”)?

YesNoClear Selection

Will you provide personal opinions or observations beyond evidence‑based content?

If “Yes” you must verbally and visually disclose this to the audience.

YesNoClear Selection

Mitigation of Potential Bias* (Minimum 1, Up to 5 selections)

Describe how you will ensure your presentation is balanced, evidence‑based, and free from commercial bias using the multi -select options

Declaration and Signature