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Forms

All disclosures should be completed in the eDisclosure system. If a person does not have access to eDisclosure because they are new, or are an external collaborator that needs to follow Northwestern's Conflict of Interest in Research policy for purposes of a research project, please add them to CERES. Once submitted for department review in CERES, the Investigator's eDisclosure profile is generated, allowing them to complete their training and disclosure requirements.

In extenuating circumstances, the disclosure forms below can be used, and returned to the NUCOI office (nucoi@northwestern.edu).

Northwestern paper disclosure forms

Northwestern Investigator Research Disclosure Form

This form should be used in exceptional circumstances only if/when a Northwestern Investigator is unable to access eDisclosure to disclose in the system.

This paper disclosure form includes a link to the page containing Northwestern's Research Conflict of Interest Training Module, which the discloser is attesting to having reviewed by signing the disclosure form.

Completed paper disclosure forms should be sent to nucoi@northwestern.edu

Subrecipient and Consultant Disclosure Forms

Subrecipient and Consultant Disclosure Form for PHS-sponsored Projects

This form should be used for all consultants deemed to be Investigators, as well as subrecipient Investigators, whose organizations have elected to follow Northwestern's COI Policy on specific PHS-sponsored projects, and specific projects sponsored by organizations that have adopted PHS regulations (e.g., American Heart Association, Susan G. Komen Foundation; a full list of sponsors can be found here). The completed form should be sent to nucoi@northwestern.edu

Subrecipient and Consultant Disclosure Form for NSF-sponsored Projects

This form should be used for all consultants deemed to be Investigators, as well as subrecipient Investigators, whose organizations have elected to follow Northwestern's COI Policy on specific NSF-sponsored projects. The completed form should be sent to nucoi@northwestern.edu

Other Forms

Student-Faculty Agreement for Student Engagement in Faculty Enterprises

This agreement should be used prior to engaging students in faculty enterprises, including startup companies and consulting activities, to ensure protection of the academic interests of such students.