- Presenters do not receive an honorarium or professional fee for their presentations (unless otherwise notified)
- Presentation is to be no longer than 50 minutes in length unless otherwise specified.
- Presenters agree not to promote a product or service during the presentation. Signing the ASA Conflict of Interest Form
signifies agreement to not promote a product or service.
- We stress that you do NOT depend on Internet connectivity for your presentation.
- Please check in at the ASA Registration Desk at least 30 minutes prior to the scheduled time of your presentation.
- If you must cancel your presentation, please notify ASA at least 30 days in advance of the dates of the conference.
- All presenters are expected to provide an electronic copy (e.g. E-mail attachment) of their presentation, e.g. Powerpoint, to the
ASA CE Department. The purpose of receiving the presentation is to place it on the ASA members only web site for our members to view post-conference.
- Please bring your presentation in electronic format (e.g. USB drive preferred) to the conference to be given to the audiovisual technician. If you prefer to use your personal MAC computer, please bring the video dongle.
CSFAs MUST be (1) A member of ASA; (2) Registered for
conference in order to be eligible to speak. CSFA must have knowledge of
the subject that is going to be presented. ASA prefers that the person has previously presented the lecture.
- Presenters must complete the ASA Speaker Packet and return by the deadline date provided in the table below.
It is essential that the forms be completed, in particular the Conflict of Interest form.
An E-mail verifying no conflict of interest is not acceptable.
Again, we want to thank you for accepting to present at our meeting.
||Speaker Profile Packet with Curriculum Vitae or resume, and Conflict of Interest form
||SEPTEMBER 15, 2018
||Send presentation to ASA in electronic format, e.g. attachment to E-mail, CD, DVD
||SEPTEMBER 15, 2018
Please include a copy of your resume or curriculum vitae that includes education that has been completed. We also use this information for your introduction.
PLEASE WRITE/TYPE LECTURE TITLE BELOW
I, , acknowledge that the Association of Surgical Assistants may utilize various
media to produce lectures, panel discussions, and handout materials presented at the annual meeting This may include presentations given by me and panel discussions in
which I participate. I further acknowledge that such compilations of these materials may be sold or provided free of charge by ASA, their agents, and representatives to registered attendees and other individuals.
I hereby give my permission to ASA, their agents and representatives, to record and distribute all or a portion of any presentation I give, papers I present,
hand-out materials I distribute and panel discussions in which I participate at the event, without any obligation on their part to pay me any fee or royalty.
In order to comply with relevant continuing education standards the ASA disclosure is to ensure that a speaker who is in the position of being able to control the content of the educational activity has disclosed to ASA all relevant financial relationships with any commercial interest (see definitions below). Upon review, if it is decided that a conflict of interest is present due to a financial relationship you, spouse or partner may have, you will be contacted to discuss methods to resolve the conflict. Additionally, all disclosures must be revealed by a slide at the beginning of the educational activity. Failure or refusal to disclose the conflict(s) could be reason for withdrawing the invitation to speak at the ASA event.
As a sponsor of continuing education for the Certified Surgical First Assistant (CSFA), ASA must ensure objectivity and balance in all the continuing education (CE) activities.
Presentations must provide a balanced view of therapeutic options. If your presentation includes the use of a drug(s), the generic name of the drug must be used. Additionally, if the presentation describes the use of a drug, medical device or product that is not FDA approved or the unapproved use of a drug, medical device or product, the speaker has the responsibility for disclosing this information to the audience during the presentation.
The intent of this disclosure is not to prevent speakers/subject matter experts with a significant financial relationship from making a presentation, but rather to provide the audience with information for their own judgment.
If speaker has identified a conflict, Executive Director may contact speaker to resolve any issues.
I have agreed to submit this application by electronic means. By signing this application electronically,
I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge.
Please type your First and Last Name
If speaker has identified a conflict, the speaker will be contacted.
Commercial Interest: AnyAny proprietary entity producing, marketing, reselling or distributing health care goods or services consumed by, or used on, patients.
Health care providers of clinical services directly to patients are not considered to be commercial interests.
Conflict of Interest: Individual is involved in one or more financial interests that could possibly be used to affect the content of the presentation as related to commercial medical products or services.
Financial relationships: Relationship(s) in which the individual benefits by receiving consulting fees, fee(s) for membership on a board, fee(s)
for membership on an advisory or review committee, honoraria, intellectual property rights, royalty, salary, speaker fees (speaker’s bureau), stocks or stock options, and/or travel benefits.
ASA includes the financial relationships of a partner or spouse.