Addendum L Conflict of Interest Make sure your Microsoft Word program is set to display “Hidden Text”. This document contains helpful information, examples, and instructions that are only visible (and will never print) when the “Hidden is enabled. be displayed highlighted yellow, italics, and underlined. Go Text” feature “Hidden Text” will to the the sure has a check mark, and click “Tools” menu, “Options”, on “View” tab make “Hidden Text” “OK”. Study Title: Name of Investigator with potential Conflict of Interest: 1. Do you, your spouse, or any of your dependents hold a patent or license for any material, object, or process used in this project? No. Yes. 2. Do you, your spouse, or any of your dependents have (a) a patent or license pending or under consideration or (b) any intention to file a patent application at a later date? No. Yes. 3. Do you, your spouse, or any of your dependents own bonds, stocks, or stock options of any amount when the value of the interest would be affected by the outcome of the research? No. Yes. 4. Do you, your spouse, or any of your dependents give presentations for or serve as a consultant or receive compensation of any amount when the value of the interest would be affected by the outcome of the research? No. Yes. 5. Do you, your spouse, or any of your dependents have any other possible conflict of interest? No. Yes. Describe:
Addendum L Conflict of Interest Make sure your Microsoft Word program is set to display “Hidden Text”. This document contains helpful information, examples, and instructions that are only visible (and will never print) when the “Hidden Text” feature is enabled. “Hidden Text” will be displayed highlighted yellow, italics, and underlined. Go to the “Tools” menu, “Options”, on the “View” tab make sure “Hidden Text” has a check mark, and click “OK”. Study Title: Name of Investigator with potential Conflict of Interest: 1. Do you, your spouse, or any of your dependents hold a patent or license for any material, object, or process used in this project? No. Yes. 2. Do you, your spouse, or any of your dependents have (a) a patent or license pending or under consideration or (b) any intention to file a patent application at a later date? No. Yes. 3. Do you, your spouse, or any of your dependents own bonds, stocks, or stock options of any amount when the value of the interest would be affected by the outcome of the research? No. Yes. 4. Do you, your spouse, or any of your dependents give presentations for or serve as a consultant or receive compensation of any amount when the value of the interest would be affected by the outcome of the research? No. Yes. 5. Do you, your spouse, or any of your dependents have any other possible conflict of interest? No. Yes. Describe:
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