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This form is used by investigators to disclose newly acquired significant financial interests that consist of sponsored or reimbursed travel in excess of $5,000 per entity, as required by the University
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How to fill out phs financial disclosure form
How to fill out PHS Financial Disclosure (Form 4)
01
Obtain the PHS Financial Disclosure (Form 4) from the official website or your institution's research office.
02
Read the instructions carefully to understand the types of financial interests that need to be disclosed.
03
Fill out the personal information section, including your name, position, and institution.
04
List all financial interests received from external sources, ensuring to include amounts and nature of the interests.
05
Provide details about any royalties, stock options, and consulting fees that may create a potential conflict of interest.
06
Disclose any significant financial interests related to your institutional research activities.
07
Review your completed form for accuracy and completeness.
08
Sign and date the form before submission as per your institution's guidelines.
Who needs PHS Financial Disclosure (Form 4)?
01
All individuals involved in research funded by the Public Health Service (PHS), including principal investigators, co-investigators, and key personnel.
02
Individuals receiving grants, contracts, or cooperative agreements from PHS or its components.
03
Researchers and faculty members who may have financial interests that could affect their research outcomes.
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What is PHS Financial Disclosure (Form 4)?
PHS Financial Disclosure (Form 4) is a form used by the Public Health Service to disclose financial interests that could potentially influence research or other federally funded work.
Who is required to file PHS Financial Disclosure (Form 4)?
Individuals who are involved in research funded by the Public Health Service, which includes Principal Investigators, co-investigators, and other key personnel are required to file Form 4.
How to fill out PHS Financial Disclosure (Form 4)?
To fill out Form 4, individuals must provide detailed information about their financial interests, including income, equity interests, and any financial relationships with outside organizations, ensuring accuracy and completeness.
What is the purpose of PHS Financial Disclosure (Form 4)?
The purpose of Form 4 is to identify and manage any potential conflicts of interest in federally funded research to ensure integrity and transparency in the scientific process.
What information must be reported on PHS Financial Disclosure (Form 4)?
The form requires reporting of various types of financial interests, such as stock ownership, consulting fees, honors, gifts, and any other financial relationships that could be perceived to influence research outcomes.
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