This biographical data and disclosure form must be completed by all persons involved in activities jointly provided by UWCNE. Refusal to disclose will result in disqualification from participant. If any potential conflicts are disclosed, steps must be taken to resolve the conflicts in collaboration with the UWCNE nurse planner prior to holding the activity.  

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Attestation: The University of Washington School of Nursing is required to "resolve" any reported conflicts of interest prior to the educational program. In light of the relationships/affiliations designated above, I attest that: 1. These relationships will not bias or otherwise influence my involvement in the program. 2. Practice recommendations given relevant to companies with whom I or my spouse/partner have affiliations will be supported by the best available evidence or, absent evidence, consistent with generally-accepted medical and nursing practice. 3. All reasonable clinical alternatives will be discussed when making practice recommendations. 4. All scientific research referred to, reported or used in support or justification of a patient care recommendation will conform to generally-accepted standards of experimental design, data collection and analysis.
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