Download Annual Disclosure Statement of External Financial Interests and External Time Commitments Survey here: Part I Part II Hard copies can be submitted: Email: asf2003@med.cornell.edu Fax: (646) 962-0533 Interoffice Mail: Box #6

Every Weill Cornell Medical College employee is required to complete the Annual Disclosure Statement of External Financial Interests and External Time Commitments Survey, even if there is nothing to disclose.

The deadline for submission is March 20, 2009.

New for FY 08-09
To simplify the disclosure process for faculty members who are also New York-Presbyterian Hospital (NYPH) Attending Physicians, there is just this one disclosure survey to complete. NYPH-specific questions have been added to the standard WCMC survey. The revised process will satisfy the reporting requirements for both organizations simultaneously.

Online Survey Frequently Asked Questions (FAQ)


Instructions - Every employee submits Part I. Depending upon your responses, you may have to complete Part II as well.

Part I of the Annual Disclosure Survey FY July 1, 2008 – June 30, 2009
Part I consists of entering your personal contact information (questions #1-9) and three Sub Parts (A, B, & C). Then there are 10 Yes/No questions. If you answer "No" to all of the questions, then the survey is complete and you are done with this requirement for the current Fiscal Year.

Those employees with an NYPH relationship who answer "Yes" to question #19 will have to continue and answer questions #20-23 and supply details where indicated.

You are also required to review/update your contact information in the People Profile. The People Profile is located on the upper right hand corner of the survey page or can be accessed at: www.med.cornell.edu/myprofile. If you are in doubt as to whether or not you completed the Annual Disclosure Survey in a specific Fiscal Year, you can check the status on My Profile. Successful completion will indicate Status as "Approved" Download Certificate – while non-compliance will indicate status as "Pending" Click Here for Training.

If you answered "Yes" to questions #10-18 or #20-23 of the Part 1 survey, you will be directed to complete Part II.

Within minutes of completing the Part I survey you will receive a confirmation email. If you answered "Yes" to questions #10-18 or #20-23 you will be sent the link that takes you to Part II where you will be asked to enter the names (entities) and details of your external financial relationships.


Part II of the Annual Disclosure Survey FY July 1, 2008 – June 30, 2009
There are two steps to this part. Your disclosure is not complete until you have completed both steps.

Step 1 Create (or update) Basic Disclosure information This step consists of a confirmation of external financial arrangements and a listing of all financial entities to be disclosed. Note – once entered, entities cannot be deleted. They can be marked "active" or "inactive" depending on the current status. Step 2 Create (or update) Financial Entity Profile(s) In this step you will detail the nature of your arrangement with each financial entity you listed in step 1.

Please note that you must create a Financial Entity profile for each individual entity. Simply listing the entity name without the details is not sufficient for fulfilling this requirement. You need not complete Part II in one session. You can save your answers by clicking on the exit button. When you resume the survey, your previously entered answers will still be there.

If your external financial relationships change during the academic year, you must amend your disclosure accordingly. The amendment process is completed using the same link and process as the annual disclosure. Save the original confirmation email for future reference, in case you need to complete or update your entity information at another time.

If you need further explanation about Part II, please contact Amenophis Faussett at (646) 962-8199 or by email: asf2003@med.cornell.edu or conflicts@med.cornell.edu

	Downloads

Conflicts of Interest and Commitment Policy and Instructions for Annual Disclosure Booklet (pdf download)

For all pdf documents

For security purposes, please quit your web browser after completing the survey.


Contact

Amenophis Faussett
Conflicts Program Manager
Telephone: (646) 962-8199
Fax: (646) 962-0535
Email: asf2003@med.cornell.edu