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Conflict of Interest Forms

Disclosure Requirements and Chart

For an overview of requirements, review the COI Disclosure Chart

Each required form must be submitted at the time of proposal submission. Make sure that the form is signed and dated and that all the necessary boxes are checked and all information requested is provided. Note that these forms are modified from time to time. The current forms are on this website. Be sure to submit the current form. The disclosure form(s) must be submitted at the time of proposal submission.  

An interactive version of a COI form may be completed and submitted electronically for all COI forms except the California Form 700U, which must be printed out, signed, and dated. Send a copy of Form 700U with the electronic proposal.

State of California Form

Please submit only the one page form of Form 700U, and not the two pages of instructions. Under California law, the original signed and dated Form 700U must be submitted, and electronic signatures are not acceptable. 

For proposals that are submitted electronically, include a copy of Form 700U, and send the original signed Form 700U (with the Proposal Number in the upper right corner adjacent to "ID") to the COI Division (Box 0962).

• Statement of Economic Interests for Principal Investigators FPPC Form 700-U (Revised 2008/2009)

Federal Forms

• Principal Investigator Certification Form (.pdf, 39.6 kB, info) (Revised 08/2009)
• Disclosure of Financial Interests (word, 38.4 kB, info) (Revised 08/2009)

Committee on Human Research Application

Please complete and submit the following form with the CHR application, but do not send a duplicate to COIAC. CHR will provide a duplicate of the form to COIAC.

• UCSF CHR Financial Interest Supplement: Disclosure of Investigators’ Financial Interests (.doc, 36.9 kB, info) (Revised 7/2009)

Privately Sponsored Clinical Studies

• COIAC Compliance with UCSF Policy #11 (9/2009)

COI Questionnaire

The "COI Questionnaire" is submitted only upon request by COI staff. Please print the instructions for completing the COI questionnaire.

• COI Questionnaire (4/2009)
• Instructions for Checking the Boxes (.pdf, 68.9 kB, info) (8/2009)