Year 2014 Conflict of Commitment and Interest

Disclosure of Information Form for Non-Tulane Employees

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Introduction

Tulane University's mission is to create, communicate, and conserve knowledge in order to enrich the capacity of individuals, organizations, and communities to think, to learn, and to act and lead with integrity and wisdom. Accordingly, the University recognizes that its Faculty and Staff enjoy productive and responsible collaboration and synergies achieved through thoughtful partnerships that benefit the participant and the University, its students, patients, and the public at large. The University, Faculty, and Staff have a shared interest in assuring the institutional integrity of the University as well as the personal and professional integrity of the Faculty and Staff. The University is committed to maintaining the highest standards of excellence in teaching, research, patient care, and welfare.

In order to maintain such standards, the University is committed to identifying and addressing potential, actual, or perceived Conflicts of Interest and Conflicts of Commitment to ensure that the University, Faculty, Staff, and Investigators conduct research and other academic and administrative activities in a fair and unbiased manner. An integral part of that process is to gather information from Faculty, Staff, and Investigators related to potential Conflicts of Interest and Conflicts of Commitment.

Please take the time to carefully consider this information and thoughtfully complete the following COI Disclosure Form so that the University can comply with federal law and can continue to uphold the highest standards of integrity.

Which forms do I need to complete?

Affiliated PHS Investigator

Any other person other than a Faculty or Staff member, who serves as project director or principal investigator or who, regardless of title or position, is responsible for the design, conduct or reporting of research funded by the Public Health Service and conducted by the University. Affiliated PHS Investigator may include, for example, a collaborator or consultant.

Institutional Review Board (“IRB”)

Any board, committee or other group formally designated by the University to review human subjects research, and which was established and which functions and operates in conformity with Part 46 of Title 45 and Part 56 of Title 21 of the Code of Federal Regulations. IRB Members are those persons who comprise the IRB.

Investigator

Any Faculty, Staff or affiliated person who serves as a project director or principal investigator or who, regardless of title or position, is responsible for the design, conduct or reporting of research. Investigator may include, for example, a collaborator or consultant.

PHS Subrecipient

An individual or legal entity that is a subrecipient, subcontractor or consortium member under a PHS-Funded Research project for which the University is the prime recipient or direct contractor.

Subrecipient PHS Investigator

Any person responsible for the design, conduct or reporting of research funded by the Public Health Service and conducted by the University through a Subrecipient.

  Form A Form C Form D Attestation Form
Affiliated PHS Investigator/Subreceipient PHS Investigator X      
Affiliated PHS Investigator/Subreceipient PHS Investigator Conducting Human or Animal Subjects Research X X   X
Non-PHS Affiliated Investigator X      
Non-PHS Affiliated Investigator Conducting Human or Animal Subjects Research X X   X
Tulane Instutional Review Board (IRB) Member, Tulane Animal Care and Use Committee (IACUC) Member, or Tulane Research Oversight Official X   X  
Tulane Instutional Review Board (IRB) Member or Tulane Animal Care and Use Committee (IACUC) Member Conducting Human or Animal Subjects Research X X   X
Tulane Research Oversight Official Conducting Human or Animal Subjects Research X X X X

Note that there is no longer a separate Form B. Form B has been incorporated into Form A.