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Appendix B Screening Disclosure Form NAME: ___ First Middle Last OTHER NAMES YOU HAVE USED: ___ CURRENT PERMANENT ADDRESS: ___ Street City Province Postal DATE OF BIRTH: ___ GENDER IDENTITY: ___ Month/Day/Year
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How to fill out appendix b screening disclosure

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Read the instructions for completing Appendix B screening disclosure form
02
Provide accurate information about the screening process
03
Include any relevant details about the screening procedure

Who needs appendix b screening disclosure?

01
Any organization or individual involved in conducting screenings as part of their professional responsibilities
02
Organizations hiring employees or volunteers who will have access to vulnerable populations
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Appendix B screening disclosure is a form used to report potential conflicts of interest or affiliations that may impact decision-making or bias in a screening process.
Individuals who are involved in the screening process or decision-making process where conflicts of interest may arise are required to file the appendix B screening disclosure.
Appendix B screening disclosure can be filled out by providing detailed information about any potential conflicts of interest, affiliations, or biases that may affect the screening process.
The purpose of appendix B screening disclosure is to ensure transparency and integrity in the screening process by disclosing any potential conflicts of interest that may arise.
Information such as affiliations, financial interests, or relationships that may impact decision-making or introduce bias must be reported on the appendix B screening disclosure form.
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