Conflict of Interest (COI) Declaration Form

Conflict of Interest (COI) Declaration Form


This Conflict of Interest Declaration Form is used to declare any real, perceived or potential conflicts of interest that may arise at your organisation. 

A Conflict of Interest arises where one person (i.e. an employee) has a competing professional or personal interest which will make it difficult for them to fulfil their duties impartially. 

An example is a Sourcing Representative at your organisation that has an interest (i.e. ownership) in a supplier that is being considered by your organisation.  This interest would need to be declared by using this form and it would be highly advisable to ensure that person is not involved in any sourcing activity at your organisation that pertains to that supplier.

Promitheia recommends storing Conflict of Interest Declaration Forms securely (both electronically and in hard copy form) and maintaining an up to date register.  This form should be made readily available to your organisation.

Promitheia recommends using this template for all key / formal meetings at a minimum and circulating for comment and review prior to issuing the final (authorised) version to all attendees.