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LEGACY HEALTH
ADMINISTRATIVE
Policy #:
100.88
Origination Date:
08/2012
Last Revision Date: 03/15
SECTION:
ADMINISTRATION / MANAGEMENT
TITLE:
CONFLICT OF INTEREST IN PUBLIC HEALTH SERVICE FUNDED
RESEARCH
PURPOSE:
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How to fill out conflict of interest form:
01
Begin by carefully reading the instructions provided with the form. Make sure you understand what constitutes a conflict of interest and what information needs to be disclosed.
02
Provide your personal information, including name, contact details, and your position or role within the organization.
03
Identify any financial interests or relationships that could potentially create a conflict of interest. This may include ownership or investment in a competing company, receiving gifts or compensation from suppliers or clients, or any other situation where your personal interests could influence your decision-making.
04
Be thorough and transparent in your disclosure. Even if you think a particular relationship may not be a conflict of interest, it is better to disclose it to avoid any potential misunderstandings.
05
If applicable, provide details of any steps you have taken or plan to take to mitigate or manage the conflicts of interest. This may include recusal from decision-making, seeking prior approval from a supervisor or ethics committee, or divesting financial interests.
06
Sign and date the form, acknowledging that the information provided is true and accurate to the best of your knowledge.
07
Submit the completed form as instructed, ensuring it reaches the appropriate individual or department responsible for managing conflicts of interest.
Who needs conflict of interest form:
01
Employees: Conflict of interest forms are typically required for employees at all levels within an organization. This ensures transparency and helps identify potential conflicts that could compromise impartial decision-making.
02
Board members: Individuals serving on boards of directors or advisory boards often need to submit conflict of interest forms. This is to prevent personal interests from overshadowing the best interests of the organization.
03
Contractors and consultants: External parties engaged in business relationships with an organization may also be required to disclose potential conflicts of interest. This ensures their recommendations and actions are based solely on the organization's best interests rather than their personal gain.
04
Volunteers: In some cases, even volunteers may need to complete conflict of interest forms, particularly if they have access to sensitive information or are involved in decision-making processes.
Overall, the purpose of the conflict of interest form is to enhance transparency, minimize potential conflicts, and uphold the integrity and impartiality of the organization and its stakeholders.
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Conflict of interest refers to a situation in which a person's personal interests or loyalties conflict with their professional obligations.
Who is required to file conflict of interest in?
Individuals who hold positions of authority or responsibility, such as government officials, board members, or employees of organizations, are typically required to file a conflict of interest form.
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To fill out a conflict of interest form, individuals usually have to disclose any relationships, financial interests, or other factors that could potentially influence their decision-making in their professional role.
What is the purpose of conflict of interest in?
The purpose of conflict of interest forms is to promote transparency and accountability, and to help prevent individuals from making decisions that could be biased or influenced by personal interests.
What information must be reported on conflict of interest in?
Typically, individuals are required to report any financial interests, relationships, or other potential conflicts that could impact their decision-making in their professional role.
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