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Yearly COI Disclosure Survey


John Muir Health (JMH) has established guidelines and procedures to ensure that the design, conduct, and reporting of research promotes objectivity and maintains public trust as determined by JMH policy and institutional processes. As such, investigators are required to disclose potential or actual financial conflicts and attest to understanding of and compliance with JMH’s Conflict of Interest in Research (COIR) policy.

A current COIR Disclosure Form is required at minimum annually in order to maintain an active Investigator status at our site.  This COIR disclosure satisfies the clinical research requirement specifically and does not replace any additional reporting obligations you may have per JMH AD- Conflict of Interest Disclosure Policy for Medical Staff Members policy.
Our records indicate a COIR disclosure form is now due for you and must be completed in order to remain compliant and participate in research at JMH. An electronic link to this form may also be provided; however, you also have the option to complete a paper version of the form (see enclosed form).  Please answer all questions.  Definitions can be found on the final page.

If you have any question, please contact the research office at (925)674-2580. Once completed, you may fax the form to (925) 674-2485 or call our office for a pick-up. 
We are dedicated to helping you meet these requirements and thank you in advance for your time and assistance.

Parveen Sra
Director, John Muir Clinical Research Center

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