MSBI Principal Investigator Certification

MSBI Principal Investigator Certification Short Form for Project Renewal

MSBI Addendum – Add Investigators to PI Certification


Disclosure of Significant Financial Interests

Investigators engaged in research must report details of any significant financial interest held by the Investigator and family members (defined as spouse and dependent children) related to the Investigator's institutional responsibilities. Investigators are defined as individuals with responsibility for the design, conduct or reporting of research. Mount Sinai Beth Israel Investigators use the web-based COI-SMART system to submit these reports. A disclosure statement must be submitted via COI-SMART before engaging in research, re-submitted annually and updated within thirty days if relevant circumstances change.

Investigators initially access the system when they receive an email from the COI-SMART system. That email includes a link that brings them to a login screen. The first time they access the system they will be asked for a user name, which is the same as their CHP Outlook email address, and they will be asked to set a unique password. They will then be brought to an announcement screen, which will introduce them to the COI-SMART system. To complete the questionnaire, respondents proceed through a series of screens to answer questions. Investigators should be prepared to give other identifying information for their current research such as IRB number(s), as well as to specify significant financial interests. Investigators who need assistance with this system should contact


MSBI Principal Investigator Certification Form

MSBI Principal Investigators must include a fully completed and signed MSBI Principal Investigator Certification form with an initial Institutional Review Board application or other grant or contract submission. This four-part form functions as follows:

  • Project Cost Status: Outline anticipated costs and funding sources for the project and document Chair level certification of the project cost status for all departments involved in the project.  Please note: the first part of the form must be signed by the department Chair or person designated by the Chair for this purpose;
  • Investigator List: Declare the name, department and research site of involved Investigators, initiating institutional review of the conflict of interest compliance status (disclosure and training) of the named Investigators.
  • Checklist:  Supply functional information for all projects with specific subsections for externally funded project proposals and clinical trial research projects;
  • Principal Investigator Certification:  Signature of the Principal Investigator.

MSBI Principal Investigator Certification – Short Form for Project Renewal

Addendum - ADD Investigators to PI Certification Form

Principal Investigators use the MSBI Addendum – Add Investigators to PI Certification form to declare the name, department and research site of Investigators added to their project’s roster subsequent to submission of a complete MSBI Principal Investigator Certification form. The MSBI Addendum-Add Investigators to PI Certification form should show only newly added Investigators as described above.  There is no need to repeat Investigator data already submitted. 

For assistance or inquiries regarding the forms or conflict of interest compliance status of Investigators, please contact the Grant Manager or email

Submit completed forms to