Western Section American Urological Association (WSAUA) Disclosure Statement

In order to ensure balance, independence, objectivity, and scientific rigor in all WSAUA educational and governance activities, individuals participating in such activities are expected to disclose their private financial or institutional interests related to health care or to WSAUA activities, business transactions, presentations or publications. WSAUA does not view the existence of these interests or commitments as necessarily implying bias or decreasing the value of participation in organization activities. The intent of disclosure is to allow others to make an informed decision about the existence and impact of potential conflicts – including necessity for refusal or disqualification under extraordinary circumstances.
 
Please consider your WSAUA activities and provide below disclosures of possibly conflicting material interests or commitments based on the following relationships.

(A) Affiliation. Membership on the board of directors, officership, editorial position, or status as a paid employee or paid or non-paid consultant in any proprietary interest producing health goods or services, including any health publishing, internet, e-commerce entity.

(O) Ownership. Personal holdings in any commercial entity, including any publishing, internet, e-commerce or other business interest that provides products or services related to health care or to WSAUA activities.

(C) Compensation. Support from commercial or other sources, including any publishing, internet or e-commerce organizations, related to health care or to WSAUA activities. Income includes stock options in, royalty arrangements with, or dividends from the commercial entity, dividends from the commercial entity, payment for speaking engagements (exclusive of reimbursable travel costs) or in-kind payments within the past twelve months.

If these criteria do not apply to you, please leave the following section blank and go to the end of the form to complete and submit.

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Any member of the WSAUA who refuses to complete a disclosure history will be prohibited from participation in a WSAUA Committee, Council, Educational Course, or Publication. WSAUA members shall be encouraged to report, in confidence, apparent violations of the disclosure policy by others. Sanctions shall be applied, following appropriate investigation, by recommendation of the WSAUA Judicial & Ethics Council to the WSAUA Board of Directors. Criticism is reserved for those who a) subordinate the interests of the Association to their private interests, b) fail to make appropriate disclosure of their competing interests, or c) in some circumstances, fail to avoid unnecessary and unjustified appearance of conflict of interest.

Failure to comply with the disclosure policy shall be considered cause for sanctions, which may include removal of a WSAUA member from office or appointment, recusal from review of abstracts or material regarding which a conflict exists, exclusion from participation in the affected WSAUA activity, or authorship of submitted materials, and where egregious, expulsion from WSAUA or other sanctions prescribed by Article X of the WSAUA Bylaws. See AUANET.org for complete text of the AUA Disclosure/Conflict of Interest Policy.
By submitting this form, you confirm that the information you have provided is complete and accurate.
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