Faculty Disclosure Of Commercial Interest {QME 119}

QME Form 119 - FACULTY DISCLOSURE OF COMMERCIAL INTEREST. This is a required statement for education providers accredited by the California Division of Workers’ Compensation. The form ensures that Qualified Medical Evaluator (QME) continuing education courses maintain objectivity by requiring faculty members to disclose any financial interests, affiliations, or commercial relationships related to the products or services discussed in their presentation. Faculty must identify the course, presentation title, and date, then indicate whether they or their family members have any relevant financial ties such as grants, consulting arrangements, speaker bureau participation, stock ownership, or other material interests. www.FormsWorkflow.com