Disclosure of Significant Financial Interests

Principal Investigator Certification Form

Addendum - ADD Investigators to PI Certification Form


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. Effective 8/24/12, a Disclosure of Significant Financial Interests form must be submitted before engaging in research initiated after that date, at least annually thereafter, and updated within 30 days if relevant circumstances change.

Mount Sinai St. Luke's Roosevelt Investigators should complete the Disclosure of Significant Financial Interests form located on this site and e-mail that disclosure to: awards-slrhc@chpnet.org

 

Principal Investigator Certification Form

Principal Investigators must include a fully completed and signed Principal Investigator Certification form with an initial or renewing Institutional Review Board or IACUC application or other grant or contract submission.   By the PI’s electronic signature/submission of the Principal Investigator Certification form, the PI attests to the following:

  1. All Investigators for the project being submitted have been identified and listed;
  1. All Investigators have submitted annual and/or updated Disclosure of Significant Financial Interests at the investigator's primary site. Mount Sinai St. Luke's Roosevelt Investigators complete the Disclosure of Significant Financial Interests form available on this website and submit via e-mail to the Mount Sinai St. Luke's Roosevelt Office of Grants and Research Administration.  If an Investigator has not previously submitted an annual Disclosure of Significant Financial Interests, or has a new significant financial interest, an updated Disclosure of Significant Financial Interest form is required prior to submission of the Principal Investigator Certification form.
  1. All named Investigators have completed conflict of interest training via the on-line CITI system. No document attachment is required for Investigators who complete training via the CITI system;
  1.  The PI has reviewed with each Investigator whether any significant financial interest represents a real or potential conflict of interest for a submitted project, and has indicated this status on the Principal Investigator Certification form.

For assistance with inquiries regarding the conflict of interest disclosure status and training status of Investigators, please contact the Grants Manager or other individuals named on the “Contacts” page for Mount Sinai St. Luke's Roosevelt, or email awards-slrhc@chpnet.org


Addendum - ADD Investigators to PI Certification Form

Principal Investigators use the Addendum – Add Investigators to PI Certification form to declare the names of Investigators added to their project’s roster subsequent to submission of a complete PI Certification form, to affirm that the required training has been accomplished and to affirm that a conflict of interest disclosure has been submitted for each added Investigator to the Office of Grants and Research Administration (OGARA).  The 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 projects submitted to the Institutional Review Board prior to 8/24/12, Principal Investigators must submit a complete PI Certification form to add Investigators to the project roster. 


For assistance with inquiries regarding the conflict of interest disclosure status and training status of Investigators, please contact the Grants Manager or other individuals named on the “Contacts” page for Mount Sinai St. Luke's Roosevelt or email awards-slrhc@chpnet.org.

 


Submit completed forms to awards-slrhc@chpnet.org.

 

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