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Faculty Disclosure Form

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FACULTY DISCLOSURE FORM

Faculty Information

Date of initial appointment:    Campus phone:

Disclosure Summary — Check all categories that apply

Check any item below that currently applies to you or to which you reasonably expect to give rise to a conflict of interest, and provide full details in the corresponding description fields.

Detailed Descriptions

For each checked category above, provide a complete description including names of organizations, nature of relationship, estimated annual compensation or value, role or title, and whether the activity occurs during contracted institutional time.

Aggregate estimated annual personal income from disclosed financial interests: $

Certification and Acknowledgment

I certify that the information provided in this form is accurate, complete, and current to the best of my knowledge. I acknowledge my continuing obligation to disclose any material change in the information reported herein within 30 calendar days of becoming aware of such change. I understand that the institution may review disclosed information and may take steps it deems appropriate, including management plan development, reassignment of duties, or recusal, to address potential conflicts of interest. Failure to disclose a relevant interest or material misrepresentation of information may result in disciplinary action in accordance with institutional policies.

I authorize the appropriate institutional compliance or administrative offices to review and retain this disclosure for audit and compliance purposes. I understand that certain disclosures may be shared with funding agencies, collaborators, or oversight committees as required to manage conflicts of interest.

Printed Name:

Signature:

Date:

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What the Faculty Disclosure Form is and when it applies

A Faculty Disclosure Form documents potential conflicts of interest and outside activities for university or research faculty. It records financial interests, consulting, advisory roles, intellectual property, and sponsored research that could influence teaching, research, or institutional responsibilities. Institutions use the form to assess, manage, and disclose conflicts under institutional policy, sponsor rules, and applicable federal standards. Faculty Disclosure Forms are commonly required at hire, upon receiving external funding, when a significant change occurs, and through annual renewal to maintain transparent institutional oversight and compliance.

Why accurate disclosure matters for faculty and institutions

Completing a Faculty Disclosure Form protects research integrity, preserves public trust, and ensures compliance with institutional policies and sponsor requirements. Clear disclosure helps administrators evaluate and manage conflicts, supports responsible use of federal funds, and reduces legal and reputational risk for both individual faculty and the institution.

Why accurate disclosure matters for faculty and institutions

Who typically completes and reviews faculty disclosures

Faculty members submit the form; institutional offices review and act on it.

  • Faculty and investigators who have external income, equity, consulting, or sponsored research interests
  • Department chairs and conflict-of-interest committees responsible for review and management plans
  • Sponsored programs and compliance officers who track disclosures for federal reporting

Each campus assigns reviewers and retention responsibilities—know your department’s routing and review timeline.

Step-by-step: completing and submitting the disclosure

Follow these sequential steps to complete the Faculty Disclosure Form and move it through institutional review.

  • 01
    Prepare documents: Gather contracts, award notices, and equity statements before you start.
  • 02
    Complete fields: Fill required fields, using MM/DD/YYYY and clear financial ranges.
  • 03
    Attach evidence: Upload supporting documents like award letters or contracts.
  • 04
    Submit for review: Route to department and COI office per campus workflow.

Core components every professional Faculty Disclosure Form should include

A well-structured Faculty Disclosure Form captures required details in standardized sections to support review, reporting, and recordkeeping across institutional and sponsor requirements.

Identification and role

Clear fields for full legal name, institutional title, department, campus affiliation, and contact information so reviewers can quickly confirm identity and routing.

Disclosure period

Defined effective date and look-back period for reportable interests, with guidance on fiscal year or sponsor-specific reporting windows to ensure consistent evaluation.

Financial interest details

Structured entries for entity name, ownership percentage or dollar range, compensation type, and whether the interest is related to institutional duties for precise conflict assessment.

Outside professional activities

Sections for consulting, advisory boards, paid speaking, and volunteer positions with estimated time commitments and compensation disclosures to evaluate time and resource conflicts.

Sponsored research and IP

Fields for sponsored projects, source of funding, subcontract status, and intellectual property interests that could affect research objectivity or institutional obligations.

Certification and approvals

Signature block, date, and checkboxes for attestations; administrative fields for reviewer findings, management plans, and final disposition tracking.

Required information fields at a glance

Full Legal Name: Exact name
Title / Department: Official unit
Disclosure Period: Start and end dates
Financial Interest: Entity and range
Sponsored Projects: Award identifiers
Signature / Date: Signed and dated

Digital submission, signing, and platform considerations

Use a secure platform that supports audit trails, authenticated signers, and retention of a tamper-evident record.

  • File formats: PDF or DOCX accepted
  • Authentication: Email, SMS, or institution SSO
  • Audit trail: IP, timestamp, and action log

Ensure the chosen system meets institutional policies and any sponsor or regulatory security requirements before accepting electronic submissions.

How to set up an online disclosure workflow

Configure a clear routing and field rule set so disclosures move automatically from faculty to department and COI reviewers.

Field Configuration
Signature Field Placement Required at end of form
Conditional Fields Show follow-up questions when interests reported
Authentication Level Use SSO or SMS code
Routing Rules Auto-send to chair then COI office

Typical submission and review flow

A standard online process minimizes manual handoffs and accelerates review while preserving audit logs.

  • Upload: Faculty opens form and attaches documents
  • Sign: Faculty signs electronically and certifies accuracy
  • Route: System forwards to chair and COI office
  • Resolve: Reviewers record management plan or clearance

Common deadlines and timing expectations

Institutions set specific deadlines; these are typical timing triggers to monitor and meet.

At hire or appointment:

Submit initial disclosure immediately on appointment

Annual renewal:

Complete yearly by institution-specified date

New funding awarded:

Disclose within 30 days of award

Material changes:

Update within 30 days of status change

Reviewer response time:

Departments typically respond within 30–60 days

Common mistakes to avoid when preparing a disclosure

  • Underreporting minor equity or consulting income because of uncertainty; always disclose amounts or ranges rather than omitting them.
  • Failing to attach supporting documents such as award letters or contracts, which leads to requests for more information and delays in clearance.
  • Using abbreviated or informal entity names that prevent reviewers from identifying the correct company or fund; use full legal entity names.
  • Signing without confirming institutional policy applicability for specific sponsors, which can create noncompliance for federal funding rules.

Consequences and compliance risks of incorrect or late disclosures

Research Sanctions: Funding restrictions
Institutional Discipline: Performance or employment action
Reputational Harm: Public trust erosion
Contractual Breach: Sponsor penalties
Audit Findings: Corrective actions required
Legal Liability: Possible civil penalties

Real-world examples of disclosure use and outcomes

These examples show common scenarios and how disclosures support decisions and compliance.

University Research Disclosure

A principal investigator discloses equity in a start-up

  • The university requested a management plan limiting student oversight
  • The plan preserved the research while managing perceived conflict and maintaining sponsor compliance.

Clinical Faculty Disclosure

A clinician reported paid consulting with a device manufacturer

  • Reviewers assessed patient-care impact and financial ties
  • A disclosure-led oversight arrangement allowed continued translational work with enhanced transparency and oversight.

Practical tips to improve accuracy and reduce review time

Apply these practices to make disclosure completion efficient and decrease follow-up requests from reviewers.

Prepare supporting documents
Attach award letters, contract pages, and equity statements at submission to avoid reviewer requests and speed clearance.
Use full legal names
Enter exact entity and institution names; ambiguous or abbreviated names cause search and verification delays.
Report ranges clearly
Provide dollar ranges or percentages when precise amounts are confidential; ranges are acceptable and facilitate assessment.
Update promptly
Submit an amended disclosure within 30 days of any material change to ensure continuing compliance.

Representative eSignature vendor comparison for completing the Faculty Disclosure Form

Vendor pricing and features vary; the table below shows starting prices and select capabilities relevant to institutional disclosure workflows.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by plan Varies by plan Varies by plan Varies by plan
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently asked questions about Faculty Disclosure Forms and eSubmission

Answers to common questions about validity, notarization, updates, and data protection for disclosure submissions.


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