Organizations accredited by the ANCC are required to identify and mitigate for any bias resulting from financial relationships with ineligible companies by individuals in a position to influence and/or control the content of accredited education. **Ineligible Companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Examples of such organizations include: • Advertising, marketing, or communication firms whose clients are ineligible companies • Bio-medical startups that have begun a governmental regulatory approval process • Compounding pharmacies that manufacture proprietary compounds • Device manufacturers or distributors • Diagnostic labs that sell proprietary products • Growers, distributors, manufacturers or sellers of medical foods and dietary supplements • Manufacturers of health-related wearable products • Pharmaceutical companies or distributors • Pharmacy benefit managers • Reagent manufacturers or sellers All individuals in a position to influence and/or control the content of accredited education are required to disclose to us and subsequently to learners: (1) any financial relationship(s) they have or have had with ineligible companies for 24 months prior to the activity, or (2) if they do not have a relevant financial relationship with an ineligible company. Failure to provide disclosure information in a timely manner prior to the individual’s involvement will result in the disqualification of the individual from participating in the accredited education.

- ANCC focuses on financial relationships with ineligible companies during the 24 months prior to the activity. - There is no minimum financial threshold; we ask that you disclose all financial relationships, regardless of the amount, with ineligible companies. - You should disclose all financial relationships regardless of the potential relevance of each relationship to the education. - Examples of financial relationships include employee, researcher, consultant, advisor, speaker, independent contractor (including contracted research), royalties or patent beneficiary, executive role, and ownership interest. - Individual stocks and stock options should be disclosed; diversified mutual funds do not need to be disclosed. - Research funding from ineligible companies should be disclosed by the principal or named investigator even if that individual’s institution receives the research grant and manages the funds.

I agree to present my ostomy case in the session described above. I agree to notify the WOCN Society immediately in the event that an emergency should prevent me from participating in this session. I agree to abide by all deadlines set forth including the completion of these electronic forms and submission of slides. I warrant and represent that, to the best of my knowledge, nothing in my presentation violates any proprietary or personal rights of others (including with limitation copyright or privacy rights); is factually accurate, and contains nothing libelous or otherwise unlawful. I authorize WOCN to use my name, likeness, photograph and/or biographical data in connection with the use and promotion of the event and this session.

Attestations: Please affirm that you will uphold the following as part of your role in this accredited educational activity. - Educational materials that are part of accredited education (such as slides, abstracts, handouts, evaluation mechanisms, or disclosure information) must not contain any marketing produced by or for an ineligible company, including corporate or product logos, trade names, or product group messages. - All recommendations for patient care in accredited continuing education must be based on current science, evidence, and clinical reasoning, while giving a fair and balanced view of diagnostic and therapeutic options. - All scientific research referred to, reported, or used in accredited education in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, analysis, and interpretation. - Evolving topics are presented without advocating for, or promoting, practices that are not, or not yet, adequately based on current science, evidence, and clinical reasoning. Sessions that cover these topics must be clearly identified in the program or agenda. - Accredited education cannot include unscientific approaches to diagnosis or therapy, or education that promotes recommendations, treatment, or manners of practicing healthcare that are determined to have risks or dangers that outweigh the benefits or are known to be ineffective in the treatment of patients. - Faculty (speakers or authors) must not actively promote or sell products or services that serve their professional or financial interests during accredited education. - Only relevant relationships are disclosed to learners prior to the activity. - The slides content were not produced for or by any ineligible company. - Appropriate permission has been obtained for the use of any pictures or other previously published material. - All slides and materials used as a part of this activity adhere to HIPAA regulations. - I understand that WOCN may need to review my presentation and/or content prior to the activity and I will provide educational content and resources in advance as requested.

WOCN offers registrants handouts and educational materials as supplements to verbal presentation and needs your permission to do so. WOCN has the right to reproduce or reprint session handouts for distribution to WOCNext attendees prior to the event through a link set up on the conference website and any other format of distribution to conference attendees as WOCN sees fit. In addition, WOCN may at its sole discretion, reproduce the speaker/session materials in other educational formats including, but not limited to slides/handouts for distribution and/or sale:

WOCN reserves the non-exclusive, unrestricted, irrevocable, royalty-free license throughout the world to record in audio and/or video format and/or live stream as well as the rights to sell the live and/or recorded session individually or as part of a compilation: And I hereby confirm that I have permission to use any identifiable photographs within my presentation from the source: I have carefully read and considered each item in this attestation form, and have completed it to the best of my ability. By entering my name and date below, for the Terms and Conditions for Speakers and based on mutual consideration, I hereby understand and agree to the above conditions as listed.