To help analyze the effectiveness of my training program, and for the non-commercial purposes of the Accreditation Council for Graduate Medical Education (ACGME) and its Ophthalmology Review Committee, I hereby authorize ABO to release, in confidence, to the ACGME, the director of the program in which I have trained, and to the chair of the department of which the program is a part, the results of my performance on the examinations conducted by ABO. I also authorize ABO to use and disclose the data I submit to ABO and results of my performance on the ABO examination for ABO’s internal, non-commercial mission and purposes. Additionally, where permitted by law, I authorize ABO to release data, including personally identifiable information, to other external entities in accordance with ABO’s Data Collection, Use, and Sharing Policy. ABO may also disclose data when required by law.

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