Student Member, AAFP Board of Directors Erin Clark Margaret Miller

7/25/2019 1 of 1

Erin Clark

Student Candidate for

AAFP Board of Directors

Campbell University School of Osteopathic Medicine Current Stage of Training: MS/OMS-IV Previous leadership position/roles served: AAFP Commission Member*, FMIG Network National Coordinator*, FMIG Network Regional Coordinator

Erin Elizabeth Clark

eeclark0610@email.campbell.edu

EDUCATION

Campbell University School of Osteopathic Medicine Doctor of Osteopathic Medicine, in progress May 2020

Gillings School of Global Public Health, University of North Carolina at Chapel Hill Master of Public Health in Health Care & Prevention, in progress August 2019

California Polytechnic State University, San Luis Obispo Bachelor of Science in Kinesiology with Honors, Minors in Sports Nutrition and Biology June 2015

HONORS & AWARDS

Weiss Urban Livability Fellowship—The Graduate School at UNC Chapel Hill 2018-2019

Emerging Leader Institute—American Academy of Family Physicians May 2017 – August 2018

Special Recognition for Service to the Honors Program—Cal Poly San Luis Obispo June 2015

Outstanding Student Employee of the Year—Cal Poly San Luis Obispo April 2014

Medtronic Student Scholarship Recipient 2011-2015

LEADERSHIP EXPERIENCE

American Academy of Family Physicians Family Medicine Interest Group Network National Coordinator August 2018 – Present Commission on Education Member August 2018 – Present Family Medicine Interest Group Network Regional Coordinator January – December 2018 National Congress of Student Members Parliamentarian August 2018 Emerging Leader Institute June 2017 – July 2018

North Carolina Academy of Family Physicians Foundation Board Student Trustee January – December 2017 Alternate Delegate to National Congress of Student Members July 2017 & August 2018 Rural Health Program July 2016

Professionalism and Leadership in the Medical Setting Course Participant, Co-Director, Program Facilitator January 2016 – Present

Campbell University Chapter of the American Osteopathic Academy of Sports Medicine AOASM Chapter President and Regional Conference Chair October 2015 – November 2016

Cal Poly Club Sports Club Sports Council Chair June 2014 – June 2015

Cal Poly Women’s Lacrosse Team Captain, Community Outreach & Safety Officer September 2011 – June 2015

Cal Poly College of Science and Mathematics Ambassador, Outreach Committee Co-chair March 2013 – June 2015

Cal Poly Honors Program Task Force Member, Honors Advisory Council September 2011 – June 2015

RESEARCH & QUALITY IMPROVEMENT

Hepatitis C Committee – North Carolina Department of Public Safety April 2019 – Present Assisting with data collection and decision-making for Hepatitis C in corrections

Formerly Incarcerated Transition Program – UNC Family Medicine November 2018 – Present Conducting cost-effectiveness analysis for primary care linkage in justice-involved individuals

ENHANCED by Mom Study – East Carolina University December 2016 – May 2018 Clinical research on exercise training during pregnancy with an interprofessional team

Substance Use Recovery Program Evaluation – Healing Transitions July 2017 – August 2018 Developing and administering participant surveys for quality improvement in longitudinal treatment Designing multimedia products to disseminate for publicity, education, and fundraising purposes

Erin Elizabeth Clark – eeclark0610@email.campbell.edu – (415) 826-8694

2

Built environment and health in a rural North Carolina community January 2016 – December 2016 Compiling research and recommendations for advisement of Harnett County public officials

Injury Prevention – Cal Poly Kinesiology Department & ASI Safety January 2015 – June 2015 Analyzing injury reports & creating safety training modules at the Cal Poly Recreation Center

Health effects of strip mining in the Black Mesa region of Arizona March 2013 – June 2013 Interdisciplinary honors research project on social and physical damages of particulate matter

PRESENTATIONS

Family Medicine Education Consortium – Rye Brook, NY November 2018 Leadership in medical school; Activating Your FMIG AAFP National Conference – Kansas City, MO August 2018 FMIG Leadership Series, A Brand Idea; Program Evaluation for Substance Use Disorder NCAFP Annual Meeting – Asheville, NC December 2016 Student Poster Competition runner up for Baker’s Cyst: A Clinical Presentation North Carolina Medical Society M3 Conference – Greensboro, NC September 2016 Case presentation of Clinical Anatomy and Pathology Project More than a Motto: Cal Poly’s Learn by Doing Conference – San Luis Obispo, CA May 2015 Professional and Leadership Development through Student Employment

PUBLICATIONS

Clark, E, Isler, C, Strickland, D, Gross McMillan, A, Fang, X, Kuehn, D, Ravisankar, S, Strom, C May, L. (2019). Influence of Exercise on Maternal Lipid Levels and Offspring Morphometrics. International Journal of Obesity, 43(3):594-602.

Clark, E. Learning to step out of your comfort zone. Student Interest & Initiatives. The North Carolina Family Physician, Winter 2018.

COMMUNITY ENGAGEMENT & SERVICE

Groundwater Approach—Racial Equity Institute & UNC Graduate School January 2019 – April 2019 Interdisciplinary community project with Weiss Urban Livability Fellows on structural racism

The Raleigh Distance Project September 2017 – Present Founding member and incorporating officer of 501(c)3 organization for elite distance running Collaborating with Sarah Lesko, MD, MPH at Bras for Girls to empower girls to remain in sport

Healing Transitions July 2017 – Present Assisting at free clinic for individuals in longitudinal substance use disorder recovery program Leading group runs and providing organizational assistance with the Oak City Recovery Run Club

Campbell University Community Care Clinic October 2015 – Present Caring for uninsured or underinsured patients in student-run free clinic on interdisciplinary teams

WORK EXPERIENCE

Teaching Assistant—UNC Gillings School of Global Public Health July 2018 – Present

Strength Training Instructor—Run Raleigh Physical Therapy June 2018 – Present

Youth Lacrosse Coach—North Carolina Lacrosse Academy October 2016 – October 2017

Marathon Training Program Coach—Fleet Feet Sports, Raleigh July 2016 – June 2017

Student Ambassador—CUSOM Admissions February 2016 – May 2017

Student Manager of Aquatics & Safety—Cal Poly Associated Students, Inc. December 2011 – June 2015 Managing teams of student employees, creating programs, collaborating on university-wide projects

ACTIVITIES & INTERESTS

Athletics: three-time Boston Marathon finisher, top 100 female in 2018; training to qualify for US Olympic Marathon Trials; midfielder for Carolina Heat Women’s Lacrosse

Erin Elizabeth Clark

eeclark0610@email.campbell.edu

To the North Carolina Academy of Family Physicians,

After four fulfilling years of education in medicine and public health, I can only imagine how

many experiences are ahead. I have searched for opportunities to know and serve my community. I

have advocated for the specialty of family medicine and for the needs of students and patients. My

training as an osteopathic student has reinforced the importance of caring for the whole person in

body, mind, spirit, and relationship. I have committed to learning about and taking care of

individuals whom society silences or fears, and I have prioritized amplifying the voices of these

individuals. I have learned to give my time unselfishly to engage in service that will ultimately help

me take better care of patients. I am excited for a lifetime of learning, leading, and serving as a family

physician.

I have become a bold leader in family medicine. I credit my spark to the Professionalism and

Leadership in the Medical Setting program, from which I learned the power of storytelling and

creating relationships. I was able to serve on the NCAFP Foundation Board of Trustees to cultivate

these skills and understand the importance of representing the stories of students. When I was

selected to the AAFP Emerging Leader Institute, I practiced the principles of relationship-building

and storytelling among individuals recovering from substance use disorders. I have continued to tell

stories and build relationships through my role in the AAFP Family Medicine Interest Group

Network, first as Regional Coordinator and now as National Coordinator.

I hope to serve as the student member on the AAFP Board of Directors to amplify the

stories of students from all backgrounds within family medicine. I am prepared to succeed in this

role and I am excited for the opportunity to grow. I understand organizational structures and

policies, including when to challenge or accept the status quo. I have continued to pursue leadership

as an osteopathic medical student in an allopathic specialty organization because I value the strength

in diversity. I have been able to testify on the floor at Congress of Delegates regarding student

positions on resolutions, and I have participated in the development of AAFP policies and National

Conference proceedings on the Commission on Education. I am excited for the opportunity to

participate in growing the family medicine workforce, advocating for patients and communities, and

strengthening our commitment to health equity. As student member on the AAFP Board of

Directors, I believe I can create meaningful relationships and help to shape and share the story of

family medicine.

Erin E Clark, M4/MPH Student

Department of Family Medicine Campbell University School of Osteopathic Medicine

Post Office Box 4280 | Buies Creek, North Carolina 27506 | (910) 814-7269 | medicine.campbell.edu

July 17, 2019 Position: Student Member of the AAFP Board of Directors Applicant Name: Erin Clark To Whom It May Concern: Through the course of medical teaching, you interact with many great students. Every once in a while, you work with a truly exceptional individual; Erin Clark is one of those individuals. Therefore, it is my great pleasure to write a letter of recommendation in support of her nomination as a Student Member of the AAFP Board of Directors. I have known Erin since she matriculated to Campbell University School of Osteopathic Medicine (CUSOM) in August 2015. Being involved in her education from her first year and as faculty advisor for her family medicine residency preparation, I feel well qualified to speak on her behalf. As the Chair of Family Medicine, faculty for the Clinical Skills and Osteopathic Manipulative Medicine (OMM) courses, faculty advisor for the FMIG, and clinical preceptor for the Campbell University student run free clinic, I have had considerable interaction with Erin. She is a hard-working student who comes highly prepared for class and has excelled in both academic and extracurricular involvement. She is enthusiastic with great interpersonal skills. Since coming to medical school, Erin has been very active in Campbell University School of Osteopathic Medicine’s Community Care Clinic. This is a student-run free clinic that provides medical care to uninsured patients in the community. It is a wonderful medical support program for the community and a great opportunity for students to gain early exposure to primary care. As Chair of Family Medicine, I also serve on the board of directors for the NCAFP. As such, I can speak to Erin’s excellent contributions to the NCAFP. She has done a great job serving as the Foundation student trustee, as well as participating in their rural health program. In addition, she has gone above and beyond through her involvement, first as Regional Coordinator, and now National Network Coordinator for the AAFP.

Department of Family Medicine Campbell University School of Osteopathic Medicine

Post Office Box 4280 | Buies Creek, North Carolina 27506 | (910) 814-7269 | medicine.campbell.edu

Erin is an outstanding student who has been a great contributor to the Medical School, the NCAFP, and the AAFP. Her interim pursuit of a MPH between her 3rd and 4th medical school year further adds to her depth of knowledge and skills. She has all the makings of an outstanding future family physician and contributor to family medicine. Therefore, I enthusiastically recommend Erin Clark for nomination as a Student Member of the AAFP Board of Directors without reservation! Please do not hesitate to contact me if I can be of any further assistance in providing information regarding Erin’s qualifications. Sincerely,

Nicholas Pennings, DO Associate Professor and Chair of Family Medicine

July 8, 2019 RE: Chapter Letter of Endorsement for Erin E. Clark, Candidate for Student Member of the AAFP Board of Directors To whom it concerns: On behalf of the NCAFP Board of Directors and our Chapter’s more than 4,000 members, it gives me great pleasure to strongly endorse the candidacy of Erin E. Clark, MPH, for the position of Student Member of the AAFP Board of Directors. Ms. Clark has already been a student leader in family medicine at both the state and national level, having most recently served as the FMIG Network National Coordinator for AAFP. Ms. Clark is entering her fourth year of medical school at the Campbell University School of Osteopathic Medicine, our state’s newest medical school, which graduated its first class of medical students in 2017. In addition, she just completed work on a Master of Public Health at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill in between her third and fourth year of medical school. While at UNC, she received the Weiss Urban Livability Fellowship. Ms. Clark has been involved in her Family Medicine Interest Group and in our chapter since day one of medical school. She previously served as a student member of the Board of Trustees of the NCAFP, served as our Alternate Delegate to the 2017 AAFP National Conference, and served as a reference committee member at the 2017 National Conference. In 2017, she was chosen to participate in the year-long AAFP Foundation Emerging Leader Institute. In addition, she was selected to serve as a FMIG Network Regional Coordinator for the AAFP and has served in that role for a year before being elected as the FMIG Network National Coordinator last year. While serving as the FMIG Network National Coordinator, Ms. Clark also served as the student member of the AAFP Commission on Education and on the Subcommittee on Resident and Student Issues and the Subcommittee on National Conference Planning. She also served as Student Parliamentarian for the 2018 National Conference. During the summer between her first and second year of medical school, Ms. Clark participated in the NCAFP Foundation’s Rural Health Program, a two-week immersion into rural family medicine in North Carolina. At Campbell, Ms. Clark has been a sports medicine volunteer at the University’s athletic events and serves as a volunteer at the University’s student-run Community Care Clinic, caring for uninsured or underinsured individuals. Ms. Clark finished her undergraduate degree with a BS in Kinesiology-Exercise with honors from the California Polytechnic State University in San Luis Obispo. Ms. Clark truly believes in the mission of family medicine, particularly a focus on prevention and wellness. To that end, she serves as a Marathon Training Program Coach for Fleet Feet Sports in Raleigh and as a Youth Lacrosse Coach for the NC Lacrosse Academy. Beyond the NCAFP and AAFP, she is also a member of the American Osteopathic Association and the American College of Osteopathic Family Physicians. Our chapter cannot think of a better medical student to endorse to continue her leadership by serving as the Student Member of the AAFP Board of Directors and offer her our strongest endorsement. With best regards,

Alisa Nance, MD, RPh, FAAFP, NCAFP President cc: Gregory K. Griggs, MPA, CAE, NCAFP Executive Vice President

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Last updated: 7/15/2019 11:28:56 AM

Annual Disclosure Information Form

Conflict of Interest Disclosure for

Ms. Erin E Clark

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1. List of Boards, Employers, Offices.

Response: AAFP Commission on Education

a. (Control) List all of the organizations (including but not limited to the Academy) forwhich you or your spouse/domestic partner serve or have within the past three (3) yearsserved as any of the following:

an officer;a member of the Board of Directors;a member of the Advisory Board;a Commission member; ora committee member.

Response: none

vi. (Compensation interest) List all of the companies, businesses and otherorganizations (including but not limited to the Academy) from which you havereceived more than $5,000.00 per year in compensation in the form of wages,salaries, bonuses, honoraria or contractual payments for goods or services duringany of the last three (3) years.

Response: none

vii. (Public office) List any public office you have held in the last three (3) years,whether or not you were paid for holding such office.

2. Known Conflicts.For purposes of this Disclosure, a "Vendor" is defined as any business or organization thatyou are or become Aware of that (i) provides goods or services to the Academy, (ii) hassought to provide goods or services to the Academy within the past three (3) years or seeksto do so in the future or (iii) competes with the Academy, its products or services, or theproducts or services of any Academy affiliates (such as TransforMED or the American

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Academy of Family Physicians Foundation).

Yes

No

a. Do you have an ownership or investment interest in any Vendor of the Academy (otherthan a 5% or less ownership in a publicly traded corporation)?

Yes

No

b. Do you receive any payment (e.g., salary, consulting fee, honorarium, royalty, per diem,expense reimbursement, etc.) from any Vendor?

Yes

No

c. Are you an uncompensated consultant, officer, Commission member, or board memberof any Vendor of the Academy?

Yes

No

d. Are you aware that a member of your Family has an interest with a Vendor theAcademy of the nature described above in A through C?

Yes

No

e. Do you hold a position in a public office or institution, whether appointed, elected, oremployed, which will require participation in matters involving the Academy?

Yes

No

f. Do you have any other interests that may compete with or conflict with the interests ofthe Academy?

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Margaret Miller

Student Candidate for

AAFP Board of Directors

East Tennessee State University – Quillen College of Medicine Current Stage of Training: M4 Previous leadership position/roles served: FMIG Regional Coordinator, National Conference Chair and AAFP Commission

MARGARET JEAN MILLER (SMITH) | smithmj5@etsu.edu

EDUCATION

East Tennessee State University Quillen College of Medicine, Doctor of Medicine Class of 2020

• Rural Primary Care Track, Mountain City, Tennessee A nationally ranked rural medicine program that exposes students to the challenges that face rural health centers and patients who live in underserved areas. Four-year commitment. East Tennessee State University College of Public Health, Masters of Public Health Class of 2020

• Health Services Management & Policy Concentration

University of Tennessee (Knoxville) Bachelor of Science in Biological Sciences May 2014

• Biochemistry and Cellular and Molecular Biology Concentration 3.46/4.0 GPA

• Spanish Language Minor

LEADERSHIP EXPERIENCE

American Academy of Family Physicians (AAFP) Student Chair of National Conference 2018 – 2019

• Elected at national conference by delegation of students from each state.

• Contributed to theme and content of largest conference of medical students and residents.

• Charged with running the student congress business sessions at the conference.

• Served as a student member of the Commission on Education representing the student voice in academic issues.

ETSU Family Medicine Mentorship Program 2018 – 2020

• Working alongside one faculty member and one student to start a mentorship program between Family Medicine residents and potential Family Medicine students.

AAFP Commission on Membership & Membership Services 2018

• Appointed to represent the student voice in business surrounding special constituencies and membership.

AAFP Family Medicine Interest Group (FMIG) Regional Coordinator 2017

• Served as liaison between the FMIGs in Region 2 and the AAFP.

• Helped develop and lead workshops for students at the 2017 AAFP National Conference.

LCME Subcommittee, ETSU Quillen College of Medicine Fall 2018

• Served as a student representative during our medical school’s internal review process for accreditation.

Interprofessional Education Program (IPEP) 2015 – 2017

• Participant in the inaugural class of a two-year longitudinal interprofessional program consisting of students and mentors in medicine, pharmacy, nursing, psychology and social work, clinical and rehabilitative sciences, and public health.

Family Medicine Interest Group President 2016 – 2017

• Organized large group interest meetings for our medical school surrounding family practice, student life, residency planning, and interprofessionalism.

• Received a 2017 AAFP Program of Excellence award from the AAFP FMIG Network.

MMARGARET SMITH PAGE 2

AMSA Sexual Health Leadership Course 2015 – 2016

• Engaged in weekly training surrounding LGBT healthcare, sexual history taking, partner violence, and sexuality through the lifespan.

• Planned a SafeZone training for 40 first year pharmacy and medical students centered on becoming LGBTQ+ allies.

SERVICE EXPERIENCE

Community HealthCorps at Open Door Family Medical Center (AmeriCorps) 2014 – 2015

• Completed 1700 hours of health education service in Westchester County, NY.

• Worked to create and implement preventative health programming for sixth graders.

• Taught LifeSkills, a drug and alcohol prevention program that seeks to give middle schoolers the skills to manage strong emotions and be assertive when making decisions.

• Helped enroll patients in the online patient portal, sometimes in Spanish. Family Medicine Interest Group Tar Wars Coordinator 2015 – 2016

• Coordinated the AAFP's anti-smoking campaign for all the fourth graders of Washington County, TN.

WORK EXPERIENCE

Graduate Assistant for the Interprofessional Education Program 2018 – 2019

• As a graduate student, worked to develop curriculum designed to educate students in medicine, pharmacy, social work, public health, and nursing on team-based care and integrated health practices.

• Expanded our program from fifty to two hundred students per class to include all first year medical and pharmacy students.

• Organized eight interprofessional conference days over two semesters. Real Hot Yoga 2018 – 2019

• Worked in retail selling health memberships and merchandise while in graduate school.

Apple Inc. Aug. 2011 – Jan. 2012

• Worked in retail suggesting and selling technology products to customers.

• Presented educational workshops on applications and products to customers.

SCHOLARSHIPS & AWARDS

Gold Humanism Honor Society Inductee and current Secretary 2019 David and Jenny Marion Byrd Scholarship (student planning a career in Family Medicine) 2016 – 2020 Quillen Medicine Scholar 2016 – 2020 University of Tennessee Chancellor’s Citation for Extraordinary Community Service 2014 University of Tennessee Parents Association Leadership & Service Scholarship 2013 – 2014

CERTIFICATIONS

• Basic Life Support, 2019

• SafeZone Trained LGBTQ+ Ally

• Naloxone Rescue Trained, 2016

HOBBIES & SKILLS

Singing and music, documentaries and movies, reading, podcasts, yoga, cats Traveling: 6,000 mile solo road trip across the US in 2016; Belize (2017), Banff, Canada (2018), Thailand (2019) Working on my husband’s family farm Fluent in conversational Spanish

To the AAFP student constituents:

My name is Margaret Miller and I am a fourth year medical student at the East Tennessee State

University Quillen College of Medicine and I am writing to express my intent to run for the

American Academy of Family Physicians student member of the Board of Directors.

Over the last four years, I have greatly enjoyed my time representing students at various levels of

leadership within the Academy. Working as a Family Medicine Interest Group (FMIG) Network

Regional Coordinator, a member of the Commission on Membership and Membership Services,

and now as your Student Chair for National Conference has transformed my understanding of

health and shaped my future. But before these opportunities, I was a student like many of you at

my first conference, trying to navigate the massive Expo Hall. I showed up at seven a.m. on the

first day of my first conference to a session where the current AAFP president, Dr. Wanda Filer,

came and told a story about a newborn she had gone to see in the nursery. She’d counseled the

parents about car seats, breastfeeding, and vaccines, and discharged the family home.

Unfortunately, the mother and her three children died as a result of gun violence at the hands of

the father. She had not asked about guns in the household, and was not prepared to face this

threat to patient safety that had not been discussed in her clinical education. She’d chosen to go

into family medicine so that she could not only treat all types of patients, but be more engaged in

the policies that affect the environments in which our patients live, work, learn, and play.

Hearing Dr. Filer share this story changed my view of family medicine. While ill-informed

preceptors advised me against this specialty, here I was learning that family physicians not only

care for obstetric patients and their newborns, but also grapple with the sociopolitical issues that

perpetuate adverse outcomes and early mortality for patients outside the clinic. I was engaged by

the idea that we as physicians shouldn’t just be looking for a diagnosis, but looking to understand

the underlying issues that lead to the development of disease. At that first conference and those

following, I’ve seen students addressing gun violence, transgender health, and climate change at

our student congress. It’s where I first became engaged in the broader public health issues we

face in medicine and where I became passionate about being a part of change. Since then, it’s

been a part of my professional mission to be more involved in addressing our patient’s barriers to

good health outcomes.

The exposure to social determinants of health that happens here at National Conference inspires

us as students to become health advocates and leaders, and it has inspired me to do the same. Our

organization is special, and representing the students at the highest level of our organization is a

special privilege. My hope is that you’ll trust me with the opportunity to represent our voice in

the discussions that advance the AAFP’s mission: to improve the health of patients, families, and

communities by serving the needs of members with professionalism and creativity.

Thank you for consideration,

Margaret Miller

MD/MPH Candidate 2020

ETSU Quillen College of Medicine

7/23/2019 Non CME Conflict Of Interest

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Last updated: 7/9/2019 9:07:06 PM

Annual Disclosure Information Form

Conflict of Interest Disclosure forMrs. Margaret Jean Miller

1. List of Boards, Employers, Offices.

Response: I am a member of the COE as the Student Chair. I have also served on CMMS.

a. (Control) List all of the organizations (including but not limited to the Academy) for which you or your spouse/domestic partner serve or havewithin the past three (3) years served as any of the following:

an officer;a member of the Board of Directors;a member of the Advisory Board;a Commission member; ora committee member.

Response: None.

(Compensation interest) List all of the companies, businesses and other organizations (including but not limited to the Academy) fromwhich you have received more than $5,000.00 per year in compensation in the form of wages, salaries, bonuses, honoraria or contractualpayments for goods or services during any of the last three (3) years.

Response: None.(Public office) List any public office you have held in the last three (3) years, whether or not you were paid for holding such office.

2. Known Conflicts.For purposes of this Disclosure, a "Vendor" is defined as any business or organization that you are or become Aware of that (i) provides goods orservices to the Academy, (ii) has sought to provide goods or services to the Academy within the past three (3) years or seeks to do so in the futureor (iii) competes with the Academy, its products or services, or the products or services of any Academy affiliates (such as TransforMED or theAmerican Academy of Family Physicians Foundation).

Yes

No

a. Do you have an ownership or investment interest in any Vendor of the Academy (other than a 5% or less ownership in a publicly tradedcorporation)?

Yes

No

b. Do you receive any payment (e.g., salary, consulting fee, honorarium, royalty, per diem, expense reimbursement, etc.) from any Vendor?

Yes

No

c. Are you an uncompensated consultant, officer, Commission member, or board member of any Vendor of the Academy?

Yes

No

d. Are you aware that a member of your Family has an interest with a Vendor the Academy of the nature described above in A through C?

7/23/2019 Non CME Conflict Of Interest

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Yes

No

e. Do you hold a position in a public office or institution, whether appointed, elected, or employed, which will require participation in mattersinvolving the Academy?

Yes

No

f. Do you have any other interests that may compete with or conflict with the interests of the Academy?

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