The ISSM initiates, organizes and/or supports a variety of activities in sexual medicine research, education, training, and advocacy. The integrity of ISSM depends on avoidance of real or perceived conflicts of interest by its leaders. ISSM must insure balance, independence, objectivity, and scientific rigor in the society and all its activities. ISSM requires all individuals in positions to influence the direction of the ISSM to fill out the disclosure form below. ISSM leaders are required to disclose all financial and intellectual relationships within the past 24 months with commercial and scientific entities which have business operations in sexual medicine. A declaration of conflict of interest does not necessarily preclude an ISSM member from serving in an influential position in ISSM. However, if a precluding conflict of interest exists and cannot be resolved, ISSM may have to disqualify an ISSM leader from some or all ISSM activities. In accordance with the conflict of interest policy of ISSM, the undersigned confirms that all information below is complete and truthful.
Have you reviewed and do you understand the ISSM COI Policy?
Do you have or have you had any financial or intellectual relationships with any (commercial) entities within the past 24 months, and could such affiliations potentially introduce bias into your role in ISSM?
Please list each commercial entity with the type of relationship listed below. Please state whether the monetary value, or potential monetary value, of each relationship is worth more than 65,000 USD/year or equivalent in your local currency.
Will your position include the opportunity to promote or influence others to use specific products/services of the commercial entities you've listed above?
If the ISSM COI Committee believes there is a COI, might you agree to avoid promoting or intentionally influencing others about these goods or services in order to retain your position with ISSM?
