EVP Academic & Research Affairs

Research Conflict of Interest Forms

Forms for Covered Individuals:

  • Research Conflict of Interest Certification Form (Revised July, 2014) 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 Certification Form is submitted: 1) with the OSP Review & Approval Form for new grant or contract applications; 2) with protocol submissions to CPHS, and in some cases with protocol submissions to 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.  The Certification Form is embedded within the electronic OSP Review & Approval Form, and is included in iRIS for protocol submissions.

  • Research Conflict of Interest Disclosure Form (Revised July, 2014) Three-page form submitted by a Covered Individual who discloses any significant financial interest related to a specific proposed research project.  This form will be requested from the investigator by the Research Conflicts of Interest Office at the time a review is initiated for potential financial conflicts of interest in the research.

  • Annual on-line form submitted by all Covered Individuals (usually during January-February-March of each year).  Must be on file with UTHealth at the time of a research application, grant/contract proposal, or protocol submission.  This on-line annual Financial Disclosure Statement is also a requirement of employment for all faculty and for all FLSA-Exempt staff (position is coded as being exempt from paid overtime).

 For Researchers with Active Research COI Management Plans:

  • Form for Notifying Collaborators/Trainees of Research Related Financial Interests   This one-page form is an on-going requirement for investigators with RCOI Management Plans to inform all research collaborators and trainees about the investigator's significant financial interests that are related to the research on which the collaborator or trainee is working. The form documents the discussion between the investigator and the collaborator or trainee, is signed by both parties, and should be sent to the Research Conflicts of Interest Office at UCT 1510.