Application Form

NOTE: i) All members of any GDG/SDG are expected to divest themselves of financial investments they or their family members have, and may not participate in marketing activities, speakers’ bureau, or advisory boards of entities whose interests could be affected by the guideline or statement content. All GDG/SDG members will be asked to declare (and regularly update) all current and planned commercial, non-commercial, intellectual, institutional, patient/public activities pertinent to the potential scope of the CPG or Statement. Failure to comply with ATA policies may result in exclusion or termination of a member of a GDG/SDG.
ii) All Chairs or Co-Chairs of ATA documents must be ATA members in good standing, with competing interests declared to the ATA within the last 6 months. iii) The ATA^® supports diversity of authorship and relevant stakeholder representation. The inclusion of patient/lay representatives is encouraged, especially for clinical practice guidelines.  Final applications are approved by the ATA Board of Directors.

7. Chairs or Co-chairs of proposed document (if known):

8. Proposed additional member(s) of GDG or SDG (including methodologist or patient representatives [if relevant], add more lines as needed) (Note: Potential members should not be promised positions, without approval of the Board of Directors).