Get the free Financial Relationships Disclosure Template

This document is a template for education staff to collect information regarding financial relationships from planners, faculty, and other individuals involved in continuing education. It aims to ensure compliance with the ACCME Standards for Integrity and Independence by disqualifying individuals who refuse to disclose their financial relationships with ineligible companies.

How to fill out financial relationships disclosure template

How to fill out financial relationships disclosure template

1. Gather all relevant financial information including income sources, investments, and affiliations.
2. Start with personal information: name, position, and organization.
3. Clearly list any direct financial relationships with entities or individuals that may influence your work.
4. Specify the nature of the financial relationship (e.g., employment, consultancy, stock ownership).
5. Include dollar amounts or percentage ownership if applicable.
6. Review institutional guidelines for any required formats or specific sections.
7. Double-check the information for accuracy and completeness.
8. Submit the completed template within the designated timeframe.

Who needs financial relationships disclosure template?

1. Individuals involved in research, healthcare, or academia who may have potential conflicts of interest.
2. Researchers applying for grants or publishing their work.
3. Employees of organizations requiring transparency in financial dealings.

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What is financial relationships disclosure template?

The financial relationships disclosure template is a standardized form used to disclose financial relationships and conflicts of interest that individuals or organizations have with outside entities or sponsors.

Who is required to file financial relationships disclosure template?

Typically, researchers, faculty, and staff involved in federally funded research or those who receive funding from certain institutions are required to file the financial relationships disclosure template.

How to fill out financial relationships disclosure template?

To fill out the template, one must provide detailed information about financial interests, including the nature, amount, and duration of each financial relationship, along with any relevant supporting documentation.

What is the purpose of financial relationships disclosure template?

The purpose of the financial relationships disclosure template is to promote transparency and accountability in research by identifying and managing potential conflicts of interest.

What information must be reported on financial relationships disclosure template?

The report should include details such as the names of entities involved, the nature of financial relationships, the amount received, and the purpose of the financial relationship.