Section 2 – Received Anything of Value
Have you received anything of value ( including travel expenses and lodging ) for attending events or speaking engagements or for any activities from healthcare vendors , business partners , manufacturers , professional organizations , or pharmaceutical companies ?
* ◯ No * ◯ Yes
Please provide the name ( s ) of the organization .
Please provide the dates .
You may indicate if this is for a single date ( ex . 01 / 01 / 2023 ), month ( ex . January 2023 ), or date range ( ex . 01 / 01 / 2022 - 12 / 31 / 2022 ).
Please provide the description of the items received .
Please provide the actual or estimated value ( rounded to the nearest dollar ).
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