Sample Instructor Disclosure Statements

Primary Promotional Materials

Instructor disclosures must appear on primary promotional materials or be clearly linked there so that learners can easily find them. There must be a disclosure statement for each instructor.

Who Qualifies as an Instructor?

Anyone who presents content during the course is considered an instructor. This includes primary speakers, panelists, facilitators/moderators, parent or consumer speakers, and authors of text-based courses and poster sessions.

Individuals who support the course but do not present content are not considered instructors and do not need to engage in the disclosure process. This may include facilitators, floaters, assistants, and site managers.

Disclosure Statements

Disclosure statements must include any relevant relationships identified through the Provider’s disclosure process. Disclosures no longer need to be labeled separately as financial and non-financial relationships, although Providers who wish to continue to format disclosure statements this way may do so. In these cases, both types of relationships must be clearly labeled for each instructor. However you choose to format disclosures, you should be consistent for all instructors.

Each disclosure must address two things:

  1. instructor’s name and
  2. whether there are relevant relationships (or not).

Examples of disclosures for different combinations of relevant relationships are included below. Examples of slides with disclosures (still broken out into financial and non-financial statements) can be found here.

Single instructor: Both financial and non-financial relationships

Disclosure: Dr. Wadelmann receives royalty payments from the sale of the book Management of Closed Head Injury and the test Assessment of Language Skills in Head-Injured Patients. He is a member of the board of directors for the Association for Traumatic Brain Injury Specialists.

Single instructor: Financial but no non-financial relationships

Disclosure: Lynn Kaplan received a speaking fee for this course and receives a salary from the Traumatic Brain Injury Association, where she is the Executive Director.

Single instructor: Non-financial but no financial relationships

Disclosure: Dr. Kim serves on the board of directors of the Association for Traumatic Brain Injury Specialists.

Examples of no relevant relationship(s) statement

James Booker has no relevant relationships to disclose.

Disclosure: James Booker has no relevant relationships.

Disclosures for Multiple Instructors

Written disclosure statements for multiple instructors may appear on the primary promotional materials in a format like that described above. Each instructor must have a separate disclosure statement. As noted above, this includes primary speakers, panelists, parent or consumer speakers, and authors of text-based courses and poster sessions.

If there are many presenters, a link to a disclosure page from all primary promotional materials is acceptable. This page may take multiple forms, and you should contact your Provider Manager to discuss the best options for your course.

Lists

Lists—either included in primary promotional materials or provided via a shared link—must include the following information:

  • Instructor Name
  • Disclosure Statement

Other information that might be shared within the disclosures include:

  • Biographical Information
  • Session Title
  • Session Location
  • Learning Outcomes

If an instructor presents multiple sessions, there should be a distinct disclosure for each session.

Example with instructor name, session title, and disclosures:

James Booker, AAC for Patients With Traumatic Brain Injury

Disclosure: James Booker has no relevant relationships to disclose.

Tyler Wadelmann, PhD, Assessing Head Injury

Disclosure: Dr. Wadelmann receives royalty payments from the sale of the book Management of Closed Head Injury and the test Assessment of Language Skills in Head-Injured Patients. He is a member of the board of directors for the Association for Traumatic Brain Injury Specialists.

Lynn Kaplan, Creating Support Groups for Individuals With TBI

Disclosure: Lynn Kaplan received a speaking fee for this course and receives a salary from the Traumatic Brain Injury Association, where she is the Executive Director.

Dr. Sylvia Kim, Emotional Impact of TBI

Disclosure: Dr. Kim serves on the board of directors of the Association for Traumatic Brain Injury Specialists.

Table

A table may be useful when there are many presenters, such as for a conference or convention. The amount of information included will depend on your organization’s needs and must include the following information:

  • Instructor Name
  • Disclosure Statement

The table may also include:

  • Biographical Information
  • Session Title
  • Session Location
  • Learning Outcomes

Examples:

Table With Name and Disclosure Only

Instructor Name Disclosures
James Booker No relevant relationships to disclose.
Tyler Wadelmann, PhD Receives royalty payments from the sale of the book Management of Closed Head Injury and the test Assessment of Language Skills in Head-Injured Patients. Member of the board of directors for the Association for Traumatic Brain Injury Specialists.
Lynn Kaplan Received a speaking fee for this course and receives a salary from the Traumatic Brain Injury Association, where she is the Executive Director.
Dr. Sylvia Kim Serves on the board of directors of the Association for Traumatic Brain Injury Specialists.

Table With Name, Session Title, and Disclosures

Instructor Name

Session Title

Disclosures

James Booker

AAC for Patients With Traumatic Brain Injury

No relevant relationships to disclose.

Tyler Wadelmann, PhD

Assessing Head Injury

Receives royalty payments from the sale of the book Management of Closed Head Injury and the test Assessment of Language Skills in Head-Injured Patients. Member of the board of directors for the Association for Traumatic Brain Injury Specialists.

Lynn Kaplan

Creating Support Groups for Individuals With TBI

Received a speaking fee for this course and receives a salary from the Traumatic Brain Injury Association, where she is the Executive Director.


Dr. Sylvia Kim

Emotional Impact of TBI

Serves on the board of directors of the Association for Traumatic Brain Injury Specialists.

Start of The Course

Instructor disclosures must also be shared at the start of a course.

Relevant relationship(s)

  • Good morning: My name is Dr. Wadelmann, and I am here to discuss assessing individuals with traumatic brain injury. I am the author of the book Management of Closed Head Injury and of the Assessment of Language Skills in Head-Injured Patients test published by ABC SLP Publishers. Many of the concepts I’m presenting today are from my book and test. I receive royalty payments from the sale of these products. I’m also a member of the board of directors for the Association for Traumatic Brain Injury Specialists.
  • Good morning: My name is Lynn Kaplan, and I am here to discuss creating support groups for people with TBI. I received a speaking fee from CE to Go for this presentation, and I receive a salary from the Traumatic Brain Injury Association.
  • Good morning: My name is Dr. Kim, and I am here to discuss the emotional impact of traumatic brain injury. My disclosure is that I am on the board of directors of the Association for Traumatic Brain Injury Specialists. I do not receive compensation for my role in the organization.

No relevant relationship(s)

  • My name is James Booker, and I'm speaking on using AAC with individuals with TBI. I have no relevant relationships to disclose.

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