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DUKE UNIVERSITY Office of Research Administration CONSULTANT/COLLABORATOR FCI DISCLOSURE FORM — AWARD The United States Public Health Service (PHS) Financial Conflict of Interest (FCI) policy (effective
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How to fill out consultant FCOI disclosure award:

01
Review the instructions: Before starting, carefully read the instructions provided with the consultant FCOI disclosure award form. This will ensure that you understand the requirements and can complete the form accurately.
02
Gather the necessary information: Collect all the relevant information needed to complete the form, such as your personal details, employment history, financial interests, and any potential conflicts of interest.
03
Provide personal information: Fill in your name, contact information, and any other personal details required on the form.
04
Employment history: Outline your past and current employment positions, including the duration of each job, the institution or company, and your role.
05
Financial interests: List any financial interests or relationships that could potentially create a conflict of interest. This may include direct or indirect investments, partnerships, or consulting agreements.
06
Relationship disclosure: If you have any relationships or affiliations with organizations that may be affected by your consulting activities, disclose them in this section. This is important to ensure transparency and avoid any conflicts of interest.
07
Conflict of interest statement: Clearly state if you have any financial or non-financial conflicts of interest that could potentially influence your consulting work.
08
Signature and submission: Read the entire form thoroughly to ensure accuracy, then sign and date the document. Submit the completed form to the appropriate authority or organization as instructed.

Who needs consultant FCOI disclosure award?

01
Consultants working on projects funded by organizations or institutions that have policies requiring disclosure of conflicts of interest generally need to complete the consultant FCOI disclosure award.
02
Researchers or individuals who provide consulting services and have a potential for financial or non-financial conflicts of interest in the context of their work may need to complete this form.
03
Institutions or organizations that provide grants, funding, or contracts to consultants often require them to disclose any conflicts of interest to ensure that the objectivity and integrity of the work are maintained. Completing the consultant FCOI disclosure award is part of this process.
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Consultant FCOI disclosure award is a form that consultants must fill out to declare any financial conflicts of interest.
Consultants who are working on projects funded by organizations that require disclosure of financial conflicts of interest.
Consultants can fill out the form online or manually by providing details of their financial interests.
The purpose of consultant FCOI disclosure award is to ensure transparency and to prevent any biased outcomes due to financial conflicts of interest.
Consultants must report any financial interests, investments, or relationships that could potentially create a conflict of interest.
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