Get Disclosure Form - Best Doctors

This guide provides detailed instructions on how to complete the Disclosure Form - Best Doctors online. By following these steps, you will ensure that you properly disclose any relevant financial relationships and help maintain the integrity of the Best Doctors InterConsultation process.

Follow the steps to accurately complete your Disclosure Form.

1. Click ‘Get Form’ button to obtain the Disclosure Form and open it for editing.
2. Begin by filling in your name, the date of the InterConsultation, your BDID number, and your case number. Make sure all information is accurate, as this will be used to identify your submission.
3. Indicate whether you or your partner/spouse have any relevant financial relationships to report within the last 12 months by selecting 'Yes' or 'No'. If 'Yes', you will be prompted to provide details.
4. In the 'DISCLOSURES' section, list any financial relationships you or your partner/spouse have with commercial interests. Use the fields provided to specify the nature of the relationship, the affiliate or proprietary entity involved, and your role (e.g., employee, consultant, etc.).
5. Complete the section on unlabeled/unapproved uses of drugs or products by answering 'Yes' or 'No'. If you chose 'Yes', please specify the product name that will be referenced.
6. After reviewing all information for accuracy, you will need to provide your electronic signature by typing your name in the designated field to certify that the information provided is correct.
7. Finally, you may choose to save the form, download it for your records, print it out if needed, or share it as required. Ensure you return the form to your Best Doctors contact.

Complete your Disclosure Form - Best Doctors online today to ensure compliance and maintain the integrity of the InterConsultation process.