Declaration of external interests

Protected B when completed

Prior to completing this form, please familiarize yourself with the CIHR Policy on Conflict of Interest Prevention and Management for Scientific Directors, Members of Governing Council and Advisory Bodies and the following instructions.

The Declaration of External Interests Form is intended to facilitate communications between you, the CIHR body of which you are a member, and the Office of the Conflict of Interest Officer in ensuring the appropriate management of conflict of interest (COI).

A declaration must be made at the time of your initial appointment, annually thereafter by an established date, as well as with a substantial change of your circumstances that may give rise to COI, as soon as reasonably possible after becoming aware of the change.

When assessing the risk of actual, potential or perceived conflict of interest in your circumstances, please consider the following factors:

• whether you have a particular interest in an external entity or activity which may subject you to demands that are incompatible with your role within CIHR and may impair, or be seen as impairing, your ability to perform your duties in an objective and impartial manner;
• whether your private interests, associations and commitments could make, or be seen as making you:
  • knowingly taking advantage of, or benefiting from the position you hold or the information that you obtained in the course of your official duties for CIHR and that is not generally available to the public,
  • assisting private entities or individuals in their dealings with CIHR or the federal government where this would result in preferential treatment of the entities or persons, or interfering in the dealings between the two as to inappropriately influence the outcome.

When declaring interests, please make sure to include information about:

• the nature and extent of the interest, and
• how the interest relates to your CIHR responsibilities.

Please note that CIHR may contact you in order to obtain additional information pertaining to your declaration and to discuss measures for avoiding or mitigating a real, apparent or potential conflict of interest, should one be deemed to exist. Those measures may include declaring potential COI at the time of voting or discussing the matter in question, refraining from voting on certain items, withdrawing grant applications or, in the extreme, divesting yourself of certain financial interests or resigning from certain memberships or appointments.

Remember that a successful resolution of a COI situation depends on its early detection and its open discussion by all interested parties.

Please direct questions related to this form and declaration process to Declaration@cihr-irsc.gc.ca.