Ashlesh Murthy, MD, PhD

Midwestern University
Department of Pathology
555 31st Street
Downers Grove, IL
United States 60515

Any personal financial relationships? Yes

Organization Name Relationship

National Institutes of Health 6

American Heart Association 6

Midwestern University 6

Organization Name	Relationship
National Institutes of Health	6
American Heart Association	6
Midwestern University	6

I have disclosed to ICMI all relevant financial relationships, and hereby allow ICMI to disclose this information to learners in print.

I will include, as the first slide of any presentation, a full disclosure of any financial relationships that may influence my presentation.

The content and/or presentation of the information with which I am involved, including any presentation of therapeutic options, will be well-balanced, evidence-based, and will not promote specific proprietary business interests of a commercial interest. Any product identification will be made using the generic names to the extent possible. In addition, any off-label use of a medication will be specifically disclosed.

I have not and will not accept any additional honoraria, payments or reimbursements beyond that which has been agreed upon directly with ICMI.

I agree to provide educational content and resources in advance for review if requested by ICMI.

If I have been trained or utilized by a commercial entity or its agent as a speaker (e.g., speaker’s bureau) for any commercial interest, the promotional aspects of that presentation will not be included in any way with this activity.

If I am presenting research funded by a commercial company, the information presented will be based on generally accepted scientific principles and methods, and will not promote the commercial interest of the funding company.

To the best of my ability, I will ensure that any speakers or content I suggest is independent of commercial bias.

I will recuse myself from planning activity content in which I have a conflict of interest.

1. I will insure balance, independence, objectivity, and scientific rigor in my role in the planning, development or presentation of this CME activity.

2. I will comply with the requirements to protect health information under the Health Insurance Portability & Accountability Act of 1996 (HIPAA).

3. I will disclose any discussion or reference to unapproved or unlabeled uses of therapeutic agents or products.

4. I have input my full name below as attestation of agreement with declaration statements. Marking the check box and indicating my name is in lieu of signature and is considered an "e-signature".

Signed on 02/08/2015 by Ashlesh Murthy

Papers:
OR.25 The Role of Gap Junction Mediated Antigen Transport in Immunopathogenesis of Mucosal Intracellular Pathogens

	I have disclosed to ICMI all relevant financial relationships, and hereby allow ICMI to disclose this information to learners in print.
	I will include, as the first slide of any presentation, a full disclosure of any financial relationships that may influence my presentation.
	The content and/or presentation of the information with which I am involved, including any presentation of therapeutic options, will be well-balanced, evidence-based, and will not promote specific proprietary business interests of a commercial interest. Any product identification will be made using the generic names to the extent possible. In addition, any off-label use of a medication will be specifically disclosed.
	I have not and will not accept any additional honoraria, payments or reimbursements beyond that which has been agreed upon directly with ICMI.
	I agree to provide educational content and resources in advance for review if requested by ICMI.
	If I have been trained or utilized by a commercial entity or its agent as a speaker (e.g., speaker’s bureau) for any commercial interest, the promotional aspects of that presentation will not be included in any way with this activity.
	If I am presenting research funded by a commercial company, the information presented will be based on generally accepted scientific principles and methods, and will not promote the commercial interest of the funding company.
	To the best of my ability, I will ensure that any speakers or content I suggest is independent of commercial bias.
	I will recuse myself from planning activity content in which I have a conflict of interest.
	1. I will insure balance, independence, objectivity, and scientific rigor in my role in the planning, development or presentation of this CME activity.
	2. I will comply with the requirements to protect health information under the Health Insurance Portability & Accountability Act of 1996 (HIPAA).
	3. I will disclose any discussion or reference to unapproved or unlabeled uses of therapeutic agents or products.
	4. I have input my full name below as attestation of agreement with declaration statements. Marking the check box and indicating my name is in lieu of signature and is considered an "e-signature".