Questionnaire Overview

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A Questionnaire refers to the information requested on the COI Disclosure Form from an individual disclosing potential conflicts. Individuals are asked a series of questions related to types of relationships to 3rd parties that may constitute a conflict. Individuals must identify the specific relationship(s) and details of those relationships when they indicate they have a type of COI relationship. The questions can vary by COI Relationship Type.

When an individual indicates a COI relationship, they are prompted to provide at least one record of relationship details but can enter multiple records. The following are examples, but not all-inclusive:

COI Relationship	Questions	Answers
1. Did you receive nonprofit (NIH, AHA) or University grant(s)?	Grantor
	Type of Grant
	Scope of Grant
	Financial Amount ($)
	Start Date
	End Date
2. Did you receive royalties or in-kind benefits (e.g. travel, accommodations) from a commercial interest?	Nature of Payment (honorarium, travel)
	Name of company/commercial interest
	Financial Amount ($)
	Date

The following functionality is available from the Questionnaires group item:

• Find Questionnaire
• List Questionnaire
• Add Questionnaire
• Query Questionnaire