The California Qualified Medical Evaluator (ME) or Agreed Medical Evaluator (AME) Conflict Of Interest Disclosure Form is a document used in the state of California to ensure that Ames and AME's who are involved in a dispute or worker's compensation claim do not have any conflict of interest. The form requires the ME or AME to disclose any potential conflicts of interest that may arise in the evaluation process. This includes financial interests in the employer or insurer, any personal relationships with any of the parties involved, or any other possible conflicts. The form also requires the ME or AME to disclose any prior contact with any of the parties involved or any potential bias or prejudice that could affect the evaluation. The form must be completed and signed by the ME or AME prior to the start of the evaluation or assessment. There are two types of California ME or AME Conflict Of Interest Disclosure Forms: the Simplified Form and the Detailed Form. The Simplified Form is a brief document that requires the ME or AME to provide basic information about any potential conflicts of interest, while the Detailed Form requires the ME or AME to provide more extensive information about any potential conflicts of interest.