In order for AAED to maintain certification as a continuing education provider, all speakers must complete this form.

The American Academy of Esthetic Dentistry requires that all speakers making a presentation during its scientific sessions, and his/her immediate family, disclose any material, financial, or other relationship that may pose conflicts of interest. (Required disclosures include any relationship between the presenter and any dental related business, or other entity whose products or services may be discussed in, or directly affected in the marketplace by the presentation, that involves a financial interest or a non-remunerative position of influence, such as participation as an officer, director, or consultant.)

The requirement for disclosure is not intended to imply any impropriety of such relationship, but simply to identify such relationships through full disclosure, and to allow the audience to form its own judgments regarding the presentation. All affirmative disclosures must be revealed by a statement or slide at the beginning of the presentation. Disclosure by a presenter does not preclude the individual from participating in the program; however, the nature of this relationship must be stated so that the audience may accurately evaluate statements made about the products or services involved.

My presentation does not infringe upon any copyright or other intellectual property or proprietary right of any third party. I have obtained appropriate permission to reprint any portion of my presentation of which I am not the author.

At the time of my presentation, I will disclose to the audience any unapproved use of product that I will be discussing.