{"id":26036,"date":"2024-02-08T09:40:20","date_gmt":"2024-02-08T15:40:20","guid":{"rendered":"https:\/\/www.aae.org\/specialty\/?page_id=26036"},"modified":"2024-12-04T11:02:13","modified_gmt":"2024-12-04T17:02:13","slug":"policies-and-procedures-acknowledgment-form-2024","status":"publish","type":"page","link":"https:\/\/www.aae.org\/specialty\/policies-and-procedures-acknowledgment-form-2024\/","title":{"rendered":"Policies and Procedures Acknowledgment Form &#8211; 2024"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_75' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_75'  action='\/specialty\/wp-json\/wp\/v2\/pages\/26036' data-formid='75' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_75' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_75_7\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3><strong>CONFLICT OF INTEREST POLICY STATEMENT<\/strong><\/h3>\n<p>All officers, directors, committee members, and employees (collectively, \u201crepresentatives\u201d) of the American Association of Endodontists (AAE) have a duty to conduct the affairs of the AAE solely for the benefit of the AAE rather than for their own financial or professional gain, or that of an immediate family member, a business associate, or an organization with which the representative is associated. To assure this duty is fulfilled and there is not an appearance of impropriety, all representatives shall disclose any financial or professional interest they may have in any matter upon which they are or will be required to act on behalf of the AAE. Financial and professional interests include but are not limited to income, honorarium, grants, royalties, gifts, and entertainment from an individual, company, or sponsor conducting business with the AAE. Such disclosures of financial and professional interest shall be made in a writing submitted to the Executive Director of the AAE both upon election or appointment to a committee and on an annual basis as determined by the Board of Directors. In order to assure that all representatives working on behalf of the AAE in connection with a matter are aware of a possible conflict of interest, such disclosure shall also be made orally prior to discussion of any matter in which the representative has, or may reasonably been to have, a conflict of interest.<\/p>\n\n<p>If a representative believes that his\/her financial or professional interest will or may affect his\/her ability to act solely for the benefit of the AAE in connection with any matter, then he\/she shall refrain from representing the AAE in connection with that matter. Similarly, a representative should refrain from representing the AAE in connection with a matter if such representation would create an appearance of impropriety because of the representative\u2019s financial or professional interest.<\/p>\n\n<p>Not every financial or professional interest will compromise a representative\u2019s duty to act solely for the benefit of the AAE, but every such interest, no matter how limited, should be disclosed to the other AAE representatives. Whether disclosure of a financial or professional interest will require no action beyond the disclosure, abstention from voting on the matter, or complete recusal from discussion of the matter will be determined by the President, the committee chair, or, where appropriate, the Board of Directors or the relevant committee.<\/p>\n\n<p>Failure to comply with this conflict of interest policy by an officer, director, or committee member may result in removal from office, from the Board of Directors, or from a committee. Failure to comply with this conflict of interest policy by an employee may result in termination of employment or some lesser disciplinary action.<\/p>\n\n<p>Any questions about this Policy or whether a representative has a conflict of interest on a particular matter should be addressed to the President or to the Executive Director.<\/p><\/li><li id=\"field_75_8\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_75_8'>As an officer, director, committee or staff member of the American Association of Endodontists (AAE), I have read and understand the provisions of the Conflict of Interest Policy, agree to abide by all terms, and agree to complete a new form should my situation change during the year; I make the following disclosures (please enter N\/A if you have no conflicts):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_8' id='input_75_8' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_75_9\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_75_9'>Committees I currently serve on (please list each committee):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_9' id='input_75_9' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_75_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >REQUIRED<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_75_10'>\n\t\t\t<li class='gchoice gchoice_75_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='By clicking here I acknowledge that everything stated above is true.'  id='choice_75_10_0'    \/>\n\t\t\t\t<label for='choice_75_10_0' id='label_75_10_0' class='gform-field-label gform-field-label--type-inline'>By clicking here I acknowledge that everything stated above is true.<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_75_5\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br\/>\n<br\/>\n<hr style=\"solid black 1px!important\">\n<hr style=\"solid black 1px!important\">\n<h3><b>AAE CONFIDENTIALITY POLICY ACKNOWLEDGEMENT<\/b><\/h3>\n<p>The American Association of Endodontists (AAE) values highly the protection of confidential information. The AAE expects that its officers, directors, committee members, other volunteers and staff recognize the need for confidentiality of certain information learned or obtained by them during or incidental to their service to the Association. The ADA's Principles of Ethics and AAE's Conflict of Interest Policy must also be followed in matters of confidentiality.\u00a0<em>This includes, but is not limited to, the following:<\/em><\/p>\n<ol>\n<li>with respect to proposed or executed contracts, such persons shall keep in confidence and shall not disclose the names of the parties with whom the Association is negotiating a contract and the terms of any such contract until the Association\u2019s President or Executive Director either publicly discloses such information or the board of directors specifically authorizes such disclosure;<\/li>\n\n<li>with respect to business plans and financial, statistical or other proprietary information, such persons shall keep in confidence and shall not disclose such information regarding, belonging to or generated on behalf of the Association until publicly disclosed by AAE's President or Executive Director;<\/li>\n\n<li> Where confidentiality is for a limited period of time then the directors or committee members, respectively, shall keep in confidence and shall not disclose matters identified by the President as proprietary and confidential matters discussed at such meeting until the Association's President or Executive Director publicly discloses such information or the board of directors specifically authorizes such disclosure.<\/li>\n\n<li>When the board of directors or the Executive Committee determines that the confidentiality is intended to remain permanent, no one, including the president and executive director, may disclose such information.<\/li>\n\n<li>Members of the Nominating Committee, shall keep in confidence any deliberations during meetings of the Committee about candidates for board positions with the Association, the AAE Foundation or the American Board of Endodontics, or candidates for officer positions with the Association. The names of candidates considered are kept confidential except for the names of those candidates nominated by the committee.; and<\/li>\n\n<li>discussion held in executive session of the Board of Directors or Executive Committee may not be repeated outside of those in attendance. The Secretary shall report the topic(s) discussed in executive session (e.g., legal matters, contracts, nominations, etc.). Any motions adopted in executive session shall either be maintained in confidential minutes by the Secretary and approved by those in attendance, or reported by the Secretary in the next open session of the Board of Directors or Executive Committee.<\/li>\n<\/ol>\n\n<p>These confidentiality provisions do not apply to confidential or proprietary information which is (a) in or passes into the public domain or otherwise ceases to be of a confidential nature other than by violation of these provisions, (b) known prior to disclosure through service to the Association and such knowledge can be demonstrated by written evidence of any kind or nature, or (c) independently developed.<\/p>\n\n<p>These confidentiality provisions have no time limit.<\/p>\n\n<p>As a Board member, chair, or committee member of the American Association of Endodontists (AAE) committee, I have read and understand the provisions of this Confidentiality Statement, and agree to abide by all terms.<\/p><\/li><li id=\"field_75_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >REQUIRED<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_75_6'>\n\t\t\t<li class='gchoice gchoice_75_6_0'>\n\t\t\t\t<input name='input_6' type='radio' value='By clicking here I acknowledge the above statements'  id='choice_75_6_0'    \/>\n\t\t\t\t<label for='choice_75_6_0' id='label_75_6_0' class='gform-field-label gform-field-label--type-inline'>By clicking here I acknowledge the above statements<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_75_11\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br\/>\n<br\/>\n<hr style=\"solid black 1px!important\">\n<hr style=\"solid black 1px!important\">\n<h3><b>COPYRIGHT ASSIGNMENT ACKNOWLEDGEMENT<\/b><\/h3>\n<p>In consideration for the opportunity to participate as an officer, member of the AAE Board, or an AAE Committee, I hereby assign to the AAE, exclusively and irrevocably, all right, title, and interest, including any claim to copyright, trademark, patent, or other intellectual property that I might have in any work of the AAE to which I may have made a contribution.<\/p>\n<p>I authorize AAE to edit any work to which I may have contributed and to publish my name, likeness, and biographical data in connection with AAE's use or promotion of the work. I also waive any and all rights that I may have to attribution with respect to AAE's use of any work to which I may have made a contribution.<\/p>\n\n<p>I warrant and represent that any contribution I may make to any AAE work will, to the best of my knowledge, be original and accurate, will not be defamatory, and will not violate any rights of third parties.<\/p>\n\n<h3>By signing below I have agreed to all three sections of this document.<\/h3><\/li><li id=\"field_75_12\" class=\"gfield gfield--type-signature gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_75_12'>Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_75_12_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><input type='hidden' class='gform_hidden' name='input_75_12_valid' id='input_75_12_valid' \/><canvas id='input_75_12' width='300' height='180'><\/canvas><\/div><\/div><\/li><li id=\"field_75_13\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_75_13'>\n                            \n                            <span id='input_75_13_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                   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