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National Association of Orthopaedic Nurses (NAON) Provider Unit Commercial Support and Sponsorship Agreement Form Commercial Interest: any entity producing, marketing, reselling or distributing healthcare goods or services consumed by or used on patients, or an entity that is owned or controlled by an entity that provides the above mentioned activities. Commercial Support: financial or in-kind contributions given by a commercial interest that are used to pay for all or part of the costs of a continuing nursing education (CNE) activity. Sponsorship: financial or in-kind contributions from an organization that does not fit the category of a commercial interest that are used to pay for all or part of the costs of a CNE activity. Title of Educational Activity/Presentation: NAON Orthopaedic Nursing Review Course Education Activity/Presentation Date: Planning Committee Chair and Credentials: Commercial Support: YES NO Sponsorship Support: YES NO Tandy Gabbert, MSN, RN, ONC Section 1: Commercial Support or Sponsorship Data Name of Commercial Support or Sponsorship Company: Name of Commercial Support or Sponsorship Representative: Description of in-kind donation: Projected Cost of in-kind donation: Section 2: NAON Commercial Support and Sponsorship Policy 1. Providers of continuing nursing education (CNE) will maintain control of all planning activities and educational content. 2. Providers of (CNE) are responsible for ensuring content integrity in the presence of commercial support and sponsorship. 3. Providers of CNE will take steps to ensure that they do not endorse or promote specific commercial products or services throughout the provision of continuing educational activity. 4. Providers of the CNE will disclose all commercial support or sponsorship to the participants prior to the start of the activity and will include how the content integrity was maintained and bias was prevented. The following items will be disclosed: Who is providing commercial support or sponsorship Financial or in-kind support, including a description of the in-kind donation How the integrity of the educational program has been maintained in the presence of commercial support and sponsorship 1.2014 Page 1 of 2 5. 6. 7. 8. All of the above will be provided either verbally prior to the start of the educational activity, in writing via the syllabus or handouts and in marketing materials, or visually through prominent signage at the site of the educational activity. Providers of CNE will inform presenters in advance of educational activities that sale or endorsement of specific products or services within a NAON educational activity is prohibited. Commercial products and services must be displayed or exhibited in a separate space from the educational activity. The provider of commercial support or sponsorship will not participate in any component of the planning and implementation process of a CNE activity, including a) assessment of learning needs, b) determination of objectives, c) selection or development of content, c) selection of presenters or faculty, d) selection of teaching/learning strategies, and e) evaluation. The Commercial Support Provider or Sponsor agrees to follow the NAON Commercial Support and Sponsorship Policy. Section 3: Statement of Agreement An “X” in the box below serves as the electronic signature of the individuals completing this Commercial Support and Sponsorship Agreement form and attests to the accuracy and agreement to the NAON Commercial Support and Sponsorship Policy written above. This form requires two signatures: Planning Committee Chair and the Commercial Support Organization or Sponsor. Electronic Signature (X Required) Date: Print Name and Credentials of Planning Committee Chair (this will be signed by NAON) Electronic Signature (X Required) Date: Print Name of Commercial Organization or Sponsor Representative 1.2014 Page 2 of 2