Forms

Forms for Covered Individuals:

• Research Conflict of Interest Certification Form One-page form submitted by all Covered Individuals to certify whether they have any significant financial interest related to the specific proposed research project. The form is submitted: 1) with the SPA Review & Approval Form for new grant or contract applications; 2) with protocol submissions to CPHS and AWC; 3) with gifts, startup funds, or other internal funds designated for a specific investigator's research (submitted to the department, School, or funding decision authority); and 4) when a new research-related significant financial interest has been acquired during the life of an award or project.  

• Research Conflict of Interest Disclosure Form Three-page form submitted by a Covered Individual who discloses any significant financial interest related to a specific proposed research project. 

• Annual Financial Disclosure Statement   Annual on-line form submitted by all Covered Individuals (usually by March 31 of each year) that must be on file with UTHealth at the time of a research application, grant/contract proposal, or protocol submission.

• Subrecipient Conflict of Interest Form  This form is required from all subcontractors at the time of a research application.  Please contact your Sponsored Projects Administration representative for assistance.

Forms for Individuals with Research COI Management Plans:

• Form for Notifying Collaborators, Staff, and Trainees of Research Related Financial Interests This one-page form is an on-going requirement for individuals with RCOI Management Plans to inform all research collaborators, study team members, and trainees about the investigator's significant financial interests that are related to the research. The form documents this discussion, is signed by both parties, and should be sent to the Conflicts of Interest Office. Please contact the COI Office for assistance.