Faculty Agreement

Invited Speaker/Faculty Participation Agreement Terms and Conditions of Engagement

The Skin of Color Society (SOCS) is an Illinois nonprofit corporation whose mission is to promote awareness of and excellence within skin of color dermatology through research, education, mentorship, and advocacy. We are committed to increasing diversity and inclusion in the field of dermatology to advance patient care. (“Exempt Purpose”). In furtherance of its Exempt Purpose, SOCS endeavors to provide educational programs and content related to skin of color dermatology, which reflect the applicable standards of care and best practices.

First name:
Last name:
Credentials (MD, PhD, MPH, PA, RN, etc.):
Email:
Mobile Phone
Date of the activity:
I AGREE TO THE FOLLOWING STATEMENTS:

I am the presenting author completing this information:

I hereby consent to participate as a faculty/invited speaker and/or moderator in the SOCS Meeting the Challenge Summit: Diversity in Dermatology Clinical Trials Summit. I agree to give the Presentation(s) I am submitting (“Presentation”).

I will prepare the Presentation in PowerPoint or a digital format as instructed.

I understand the SOCS intends to record the Summit. I hereby grant SOCS a non-exclusive, royalty-free license to record the Presentation, to prepare a transcript of the Presentation, and to reprint, excerpt, display, sell, prepare translations and/or derivative works of, or otherwise make use of the Presentation, in whole or in part, in any media, whether print, audio, video, or other forms now known or hereinafter developed. I understand and agree that SOCS will acknowledge my participation in the Summit and my authorship of the Presentation, but I will receive no compensation and no other benefit with respect to the Presentation.


I hereby represent that, to the best of my knowledge: (a) The content of my Presentation is accurate; (b) The Presentation does not violate any copyright, proprietary rights, or personal rights of others; (c) The materials, including photographs and video, used in this Presentation do not identify, by name or otherwise, suggest the identity of, or present a recognizable likeness of any patient or others; or, if they do, I have obtained all necessary consents from patients and others for the further use, distribution, and publication of such materials; (d) The Presentation will be educational, will not promote any specific product or service, and will not contain any false or misleading statements regarding any products or services or include materials that are anticompetitive, slanderous, libelous, or otherwise illegal, offensive, or inappropriate; and (e) I am authorized to make these representations.


SUMMIT RECORDING (POTENTIAL ONLINE CME OFFERING)
I hereby represent that, to the best of my knowledge: (a) The content of my Presentation is I agree to conform to all SOCS and Accreditation Council of Continuing Medical Education (“ACCME”) guidelines and time limits applicable to my Presentation, should the recording of my Presentation be used for CME credits. I will fully disclose all financial support, proprietary interest, or consultant relationship with a manufacturer of a healthcare product or service (e.g., pharmaceutical, medical device) that is consumed by or used on patients that are used on patients, that is discussed in my Presentation.


SUMMIT RECORDING (POTENTIAL ONLINE CME OFFERING)
If my Presentation discusses any “off-label” or other non-FDA-approved, investigational use of a medical device or pharmaceutical product, I will disclose that the product or device is not labeled for the use under discussion or is still investigational.


SUMMIT RECORDING (POTENTIAL ONLINE CME OFFERING)
I understand that the SOCS expects the recording of the Summit to adhere to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education when CME is offered. I represent that all recommendations for patient care 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 to support or justify a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, analysis, and interpretation. Suppose my Presentation promotes recommendations, treatment, or manners of practicing healthcare determined to have risks or dangers that outweigh the benefits or are known to be ineffective in treating patients. In that case, I will specifically make the learners aware. 


SUMMIT RECORDING (POTENTIAL ONLINE CME OFFERING)
The AACME defines an ineligible company as an organization whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Examples of such organizations can be found at: https://accme.org/faq/what-accmes-definition-ineligible-company. I agree that I will not accept any financial or in-kind support from an ineligible company. This includes travel, lodging, honoraria, or any other expenses related to the education of the learners. 


SUMMIT RECORDING (POTENTIAL ONLINE CME OFFERING)
I agree that the content of my Presentation and related materials will promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest. I understand that CME must be unbiased, scientifically rigorous, and include a balanced view of therapeutic options. I will use generic names whenever possible. If I include trade names in the Presentation materials, I will make reference to the trade names of several companies where available, not just the trade names of a single company. I understand that educational materials (slides, abstracts, handouts) must not contain advertising, trade names, or product-group messages. 


I hereby indemnify and hold harmless the SOCS, its officers, directors, members, employees, and agents from and against any and all claims, expenses (including reasonable attorneys’ fees), and liabilities whatsoever arising, directly or indirectly, from any breach of my representations herein, or my actions or inaction at, or participation in, the Summit. I further waive any and all rights I may have against SOCS, its directors, officers, members, employees, and agents and release and discharge them from any claim relating to the Summit or the manner in which it is conducted.

I HAVE READ THIS FACULTY PARTICIPATION AGREEMENT AND AGREE TO BE BOUND BY ITS TERMS.

Name:
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