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Outside Interest and Outside Commitment Disclosure

ATTENTION: To login, click "Login" in upper right corner

To prepare for completing this form, you may want to collect the following documents:

  • Any consulting agreements you have signed this year

  • Your stock options agreements

  • Your stock portfolio summary

  • Your 1099 forms for the previous calendar year (January-December)

  • W-2 forms from outside employment for the previous calendar year (January-December)

Return to this site to update your disclosure at any time. Substantial changes in outside activities must be updated on the disclosure within 30 days of occurrence. Each disclosure is date stamped and archived.

If you have questions regarding the Outside Interest disclosure process, please contact the Conflict of Interest Office at (336)716-9300 or coidisclosures@wakehealth.edu.