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LOUISIANA MEDICAL PRACTICE QUESTIONNAIRE Date of completing the questionnaire ___/___/2020 Individual Name or Practice Group: Address: Completed by: Position: 1. Our team will be establishing discount
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Standard Form DOTD 24-102 is a form used for reporting financial interests and potential conflicts of interest for certain government employees.
Certain government employees who are required to disclose their financial interests and potential conflicts of interest must file Standard Form DOTD 24-102.
Standard Form DOTD 24-102 must be completed by providing information about the employee's financial interests, including assets, liabilities, and sources of income.
The purpose of Standard Form DOTD 24-102 is to promote transparency and prevent conflicts of interest by requiring government employees to disclose their financial interests.
Government employees must report their assets, liabilities, sources of income, and any financial interests that could potentially create a conflict of interest.
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