PHS Financial Conflict of Interest Information Request Form

  1. Compliance & Safety
  2. Conflict of Commitment & Interest
  3. Resources for Managing Conflict of Commitment or Interest
  4. PHS Financial Conflict of Interest Information Request Form
  5. PHS Financial Conflict of Interest Information Request Form

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Download the PHS Financial Conflict of Interest Information Request Form

Instructions for Submitting Form

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 Urbana-Champaign that is funded by the Public Health Service (PHS).mPlease complete one form for each individual investigator regarding whom information is requested, and submit the form to FCOIrequest@illinois.edu or by U.S. mail to:

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