FOR EXTERNAL NON-WCMC USE ONLY
Study Specific Report (formerly the Study Specific Financial Disclosure form)
A Study Specific Report must be submitted with each new grant proposal and or research protocol (both human and animal subjects) application. The purpose of the Study Specific report is to determine - for each study - whether there is a financial interest that needs to be managed.
A new form must be completed at the time of Continuing Review and/or Renewal and at any time thereafter if there is a change in circumstances once the project has begun.
These forms are for EXTERNAL NON-WCMC USE ONLY, otherwise please login to the new Conflicts Management System and complete the Study Specific Report.
Which Study Specific Report Form do I complete?
The appropriate form depends on whether you have a Financial Interest to disclose.
Below is the definition of what constitutes a conflict of interest and therefore requires the form "Financial Interest to Disclose". The following are examples of Financial Interests that need to be reported:
- Receive honoraria or royalties for books, publications or lectures
- Equity Interests (e.g., stocks, stock options, or other ownership interests)
- Receive a salary as an employee of an external entity (salary from a non-WCMC entity)
- Serve as a consultant, member of a speakers bureau, member of a scientific advisory board, etc.
- Serve on a Board of Directors or Advisory Board
- Serve as an executive or officer in an External Entity
- Intellectual property rights (e.g., patents, copyrights, and royalties from rights)
- Salary, royalties, or other remuneration from the Institution
- Any ownership interests in the Institution, if the Institution is an applicant under the SBIR or STTR Programs
- Income from seminars, lectures, or teaching engagements sponsored by public or non-profit entities
- Income from service on advisory committees or review panels for public or nonprofit entities
If you do not have a Financial Interest that needs to be reported please complete the form "No Financial Interest to Disclose".
| Downloads | |
|---|---|
| Guidance for Conflicts Disclosure | Adobe PDF |