Faculty Disclosure Form
AGES Society wishes to ensure independence, objectivity, scientific rigour and a fair balance of representation, in all its individual or jointly sponsored educational activities and on all committees and boards. All speakers at educational events and all authors presenting at any AGES’ meetings are required to make a declaration.
Disclosure forms must be submitted prior to each event at which the below signed is presenting at. All financial relationships at any time in the previous 12 months and any that will commence within 3 months of submission of this form must be disclosed.