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COI 2018 survey new formatting

CONFLICT OF INTEREST DISCLOSURE DECLARATION


Re: #-# title


Conflict of Interest (COI) disclosures are required for participants in Program in Evidence-based Care (PEBC) guidance development projects, in accordance with the PEBC COI policy. 

All authors, expert panel members (disease site group or guideline development group), PEBC Report Approval Panel (RAP) and targeted peer reviewers who are involved in the development of an Ontario Health (Cancer Care Ontario) PEBC document must submit a COI disclosure for each project in which they participate.  Declared conflicts will be managed in accordance with the
PEBC COI policy.

The PEBC COI declaration requires your response to questions about potential conflicts with regards to financial, ownership, professional income or other professional interests that you may have, with respect to the above named PEBC guidance document.

If you have any questions or if you wish to complete this disclosure declaration in paper format and fax or email back to us, please contact Maria Cavicchioli at
cavicch@mcmaster.ca or by telephone at 905-527-4322 ext 42823

There are 28 questions in this survey.