Conflict of Interest Disclosure Statement and Confidentiality Agreement

Please complete all applicable questions in the Conflict of Interest Disclosure Statement and the Confidentiality Agreement. Once completed, click on the "Submit" button. 

When filling in the form, use Sentence Case (e.g. John Smith) instead of all CAPITAL letters (e.g. JOHN SMITH) or all small letters (ex. john smith). Fields followed by * are required information and need to be filled in before submitting. The text boxes will enlarge automatically depending on how much text you insert. If you are copying text from another document, please paste it as simple text (to remove any formatting) into the response fields.

Should you require assistance, please contact the Association Management Office at info@capho.org.

All CAPhO Board, Committee and Task Force members will declare annually and continually any real, potential or perceived conflicts of interest, including relationships they have with any entity that supports CAPhO activities, provides services to CAPhO, is seeking CAPhO business, or that may have an interest in influencing CAPhO programs or policies.

Any CAPhO Board, Committee and/or Task Force member aware of a real, potential or perceived conflict of interest shall declare such to the President or Chair of the Board, Committee/Task Force prior to entering into discussions or decisions that are or may be in conflict. 

CAPhO maintains a process for determining, based on a Board, Committee or Task Force member's declaration, if a real, potential or perceived conflict of interest exists and for ensuring that no Board, Committee or Task Force member is engaged in CAPhO program discussions or decisions for which he or she has a real, potential or perceived conflict of interest.