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Title of the presentation. Moderator Name moderator 1st author / speaker Name fo author or speaker Co-authors Names of co-authors. Conflict of Interest Disclosure Form In accordance with the rules of the Health Care Inspectorate (IGZ). Name:. [ enter your name ]. Affiliation:.

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Title of the presentation

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  1. Title of the presentation Moderator Name moderator 1st author / speaker Name fo author or speaker Co-authors Names of co-authors

  2. Conflict of Interest Disclosure Form In accordance with the rules of the Health Care Inspectorate (IGZ) Name: [ enter your name] Affiliation: [ enter your affiliation ] ☐ ☐ I have no potential conflict of interest to report I have the following potential conflict(s) of interest to report [please delete the checkboxes to the left that aren’t applicable, then delete this yellow text box]

  3. [ Insert your presentation here ]

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