MAPS Faculty Content Development and

Conflict of Interest and Disclosure Agreement

 
 

Faculty and Content Contributor Agreement

We are pleased you have agreed to participate this exciting and impactful program. Each MAPS faculty member/content contributor, whether delivering a keynote address, co-facilitating a workshop/webinar, or moderating a roundtable, is asked to sign and submit the MAPS Content Development and Conflict of Interest and Disclosure Agreement. The purpose of this agreement is to provide protection to MAPS upon the terms and conditions set forth in this agreement.


Please complete each section and or indicate your agreement by checking the boxes.

 
 

It is the policy of MAPS that faculty/content participants will not disclose confidential information belonging to or obtained through their affiliation with MAPS to any person, including relatives, friends, and business and professional associates, unless MAPS has authorized disclosure. This policy is not intended to prevent disclosure where disclosure is required by law. Faculty are cautioned to demonstrate professionalism, good judgment, and care to avoid unauthorized or inadvertent disclosures of confidential information.


Confidential information shall mean, but is not limited to plans, processes, reports, financials, business or strategic plans, and any information relating or belonging to MAPS members, sponsors, and other third-party individuals with whom MAPS transacts business. For the purposes of this agreement, confidential information shall not include information that is

•    Readily available in the public domain

•    Has been lawfully received from an independent third party

•    Has been independently developed without access or knowledge or use of the confidential information

 

MAPS will utilize faculty information as follows to promote the program/Annual Meeting to potential attendees:


• Biography or LinkedIn profile and headshot photo as submitted and approved for use in writing (via email) posted to MAPS Website faculty page


• Approved headshot photo and LinkedIn profile to be utilized in communications to potential meeting attendees via email campaigns (e-blasts), LinkedIn posts and Twitter posts, and during MAPS Webinars


• Approved headshot photo to be included in any printed promotional materials


• Approved session details and/or presentation summaries to be shared to potential meeting attendees via email campaigns, LinkedIn, and Twitter posts, during MAPS Webinars, and in any printed promotional materials


• MAPS may request a short video testimonial and/or session/presentation description to be shared with potential attendees. Upon agreement to produce such video, faculty member agrees for MAPS to distribute the via email campaigns, social media posts, and/or during MAPS Webinars as applicable

 

By selecting the check box, I confirm that I have reviewed the following MAPS policies and agree to be in compliance with each:


Continuing Education Anti-Discrimination Policy

Intellectual Property Policy

Non-Promotion and COI Policy

Qualified Content Developer Policy

Course Content Policy

Learner Records Security Policy

 

For the right to participate in MAPS programs, for other good and valuable consideration, receipt of which I acknowledge, I hereby irrevocably grant to MAPS, its assigns, licensees and successors the right to photograph, publish, record, broadcast, digitize, display, copyright, license, transfer, reproduce, translate, modify, edit or otherwise use perpetually throughout the world, in all media now and hereafter known or devised, in whole or in part, my image, likeness, name, biographical information, actions, performance, voice, conversations and material spoken or otherwise provided by me to MAPS in connection with the MAPS activity described below, for educational, promotional or other purposes that support MAPS’ mission.


I hereby release MAPS, its officers, employees, agents, licensees, successors, and assigns, from any and all liability for damages for libel, slander, invasion of privacy, copyright infringement or any other claims based on the publication, exhibition, display, copyright, license, transfer, reproduction, editing, disposition, or other use of the materials.


I understand that MAPS is not obligated to use the rights granted to it under this Agreement.

 

Disclosure/Conflict of Interest

The standard of MAPS is to recognize and address actual relevant Conflicts of Interest as well as perceptions of Conflicts of Interest between the interests of MAPS and personal, professional, and business interest of MAPS members, volunteers, board members, committee members and governing personnel, and those presenting at MAPS events. Conflict of Interest is defined as a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations in which the personal interest of an individual or organization might adversely affect a duty owed to make decisions for the benefit of the third party.



While it is understood that all real or perceived conflicts of interest are not necessarily prohibited or harmful to MAPS, faculty members are required to disclose all material information that may pose an actual or perceived conflict of interest. The MAPS Learning and Development Committee will determine if an actual relevant conflict of interest exists and recommend steps for remediation.

 

In the past 24 months, please list all profit and nonprofit businesses/entities with which you have a financial interest (owner, employee, consultant, royalties/license holder or other) or for which you serve on governing or advisory boards where there may be a conflict or an appearance of conflict. Indicate whether such business/entity currently does business with MAPS and state the specifics of such business relationship. Also indicate whether any interests of such business/entity may be adverse to the interests of MAPS and, specifically, how. Note: please include any relationships with co presenting organizations represented at this training.

 
 

Please list any additonal relationships

 

I, the undersigned, hereby acknowledge that I have reviewed the above Agreement in full and agree to all terms.


I, the undersigned, agree to hold confidential any and all information provided to me by MAPS in accordance with the MAPS definition of confidential information.


I, the undersigned, agree that my electronic signature is the legal equivalent to my original signature.

 
 
 
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Questions

Questions or need assistance? MAPS staff are here to help. Please see our MAPS Program Support Services for a listing of our staff. If you have questions or need assistance in completing this form, please contract lroy@medicalaffairs.org