Get Coi Disclosure Form - University Of Pennsylvania - Upenn

Filling out the COI Disclosure Form is an essential step for researchers at the University of Pennsylvania to disclose any potential conflicts of interest. This guide will provide you with a clear, step-by-step overview of how to complete this form online, ensuring that all necessary information is accurately provided.

Follow the steps to successfully complete the COI Disclosure Form.

1. Click the ‘Get Form’ button to obtain the COI Disclosure Form and open it in your preferred digital editor.
2. Enter your name and the date at the top of the form. Ensure that all information is current and accurate.
3. Fill in your academic title and department/division. This section helps to identify your affiliation within the University.
4. Provide your email address and phone number for any follow-up communication related to your disclosure.
5. List the name and email address of your department chair. This provides an additional point of reference within your academic division.
6. Include the title of your research as listed in PennERA. This title is crucial for matching your disclosure with your research project.
7. Indicate whether your research involves an IRB protocol by selecting either 'Yes' or 'No' and provide the associated IRB number if applicable.
8. Reveal whether your research involves a grant, contract, or other sponsored agreement. Select 'Yes' or 'No' and provide the ORS number if applicable.
9. List all sponsors or other sources of support for your research. Be thorough in your response.
10. In Part I, check the appropriate boxes to identify any financial interests or relationships that may relate to your research.
11. Provide detailed answers for all questions regarding ownership interests, compensation, and advisory roles as related to outside organizations in Part II.
12. Complete the sections related to students and post-doctoral fellows, human subjects research, and any other relevant parts as outlined in the form.
13. In Part V, describe the relationship of your research work to any outside organizations and clarify how these might conflict with your financial interests.
14. Sign and date the certification in Part VI, confirming that all provided information is accurate to the best of your knowledge.
15. Finally, save the changes, download the completed form, and share or print it as necessary for your submission.

Begin filling out the COI Disclosure Form online today to ensure compliance with University of Pennsylvania policies.