3) Do you have any interests reported in Questions 1 or 2 that are not already subject to a conflict management plan? (Leave blank if no interests reported.)
If you had no interests to report, or if the interests reported are already subject to a conflict of interest management plan, skip Questions 4 and 5, sign below, and return this form to the appropriate administrator. Otherwise, please complete Questions 4 and 5 and go straight to question 6. A “Yes” to Questions 1 or 2 does not mean that a conflict exists, but you may be asked to provide further
information about the activity.