Sample Disclosures for Managed Conflicts

All management plans require that their managed conflict(s) be disclosed to the appropriate people/entities and sponsors. 
Reporters must disclose their financial interest in the managed entity within 30 days of the execution of a Conflict Management Plan, and annually thereafter, to ALL students, fellows, postdoctoral associates, trainees and staff who are under their supervision, or who are working on any of their research projects; to collaborators in their research that is related to the entity; to editors of journals when submitting publications, and to organizers of conferences where research results are presented that are related to the managed entity.

Below are sample disclosure texts that anyone with a management plan can use to make the necessary disclosures. 

  

Dear ______________________,                                                       

Per university policies pertaining to disclosures of potential Conflicts of Interest, I am writing to inform you that I have a financial interest in an external company, and that, in accordance with University policy, Cornell has implemented a plan to manage any real or apparent conflicts of interest resulting from that relationship.

RELATIONSHIP SUMMARY. This intersection of relationships presents a conflict of interest that must be managed. University policies require that we disclose these potential for conflicts and inform you of the principles that govern how these conflicts are managed.

A Conflict Management Plan is in effect to ensure that my relationship with ENTITY NAME does not influence or appear to adversely influence the integrity of our research, affect your ability to make academic progress or to conduct your Cornell responsibilities. This plan also guards against any undue influence on your ability to objectively design, conduct or analyze and report data and research, or publish or present results from our research.

If you have any concerns about this relationship, I invite you to discuss them with me.  You are also welcome to discuss them with Professor CONFLICT MANAGER FULL NAME, who will meet with you on at least an annual basis, or with your Faculty Advisor or Committee Chair if you are a student.  Your discussions will be kept confidential at all times.

Please sign and date this disclosure form below, return the original to me and keep a copy for your own files.

Sincerely,

REPORTER FULL NAME

Acknowledged and understood:

 

 

___________________                    _____________________                               ___________

Student Signature                              Student name                                                     Date

 

 

Dear _______________________,                                                       

Per university policies pertaining to disclosures of potential Conflicts of Interest, I am writing to inform you that I have a financial interest in an external company, and that, in accordance with University policy, Cornell has implemented a plan to manage any real or apparent conflicts of interest resulting from that relationship.

RELATIONSHIP SUMMARY. This intersection of relationships presents a conflict of interest that must be managed. University policies require that we disclose these potential for conflicts and inform you of the principles that govern how these conflicts are managed.

A Conflict Management Plan is in effect to ensure that my relationship with ENTITY NAME does not influence or appear to adversely influence the integrity of our research. This plan also guards against any undue influence on your ability to objectively design, conduct or analyze and report data and research, or publish or present results from our research.

If you have any concerns about this relationship, I invite you to discuss them with me.  You are also welcome to discuss them with Professor CONFLICT MANAGER FULL NAME. Your discussions will be kept confidential at all times.

Please sign and date this disclosure form below, return the original to me and keep a copy for your own files.

Sincerely,

REPORTER FULL NAME

Acknowledged and understood:

 

 

___________________                    _____________________                               ___________

Signature                                              Name                                                                     Date

I am writing to inform you that RELATIONSHIP AND FUNDING SUMMARY. Since the outcomes of my Cornell research may be of interest to or may be beneficial to this company, university policies require that we disclose these potential for conflicts. I have disclosed this relationship to Cornell University and it is being managed in accordance with the CU policy 1.7 on financial conflicts of interest related to research.

I am writing to inform you that RELATIONSHIP SUMMARY.

ENTITY NAME is listed as a sub-awardee of funds under the proposal (Title and OSP Number) currently under review by Sponsor Name. The outcomes of the research performed in my lab may be of interest to or may be beneficial to ENTITY NAME. I have disclosed this external relationship to Cornell University and it is being managed in accordance with University policy of Financial Conflicts of Interest related to research.

Provide a justification for the selection of ENTITY NAME as the sub-awardee and any other information you deem important to convey to the sponsor that the selection of ENTITY NAME is not biased by your financial interests.

I am writing to inform you that Per university policies pertaining to disclosures of potential conflicts of interest, we are informing you that one of the Investigators for this research project, [NAME], has a financial interest in [ENTITY NAME]. [DESCRIPTION OF FINANCIAL INTEREST AND ITS RELATIONSHIP TO THE RESEARCH]. [NAME] has disclosed this relationship to Cornell, and it is being managed in accordance with University Policy on Financial Conflicts of Interest Related to Research.