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PHS Financial Conflict of Interest Information Request Form

PHS Financial Conflict of Interest Information Request Form

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This form is to be used for all requests for information regarding the financial conflicts of interest of senior and key personnel participating in research at the University of Illinois at Urbana-Champaign that is funded by the Public Health Service.
Please complete one form for each individual investigator regarding whom information is requested.

Please submit the form to FCOIrequest@illinois.edu or by US mail to:

FCOI Information Request
Office of the Vice Chancellor for Research
University of Illinois at Urbana-Champaign
601 East John Street, MC-304
Champaign, Illinois 61820-5711

 

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