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PHS Public Access Request Form
This form must be used to request certain information regarding financial conflicts of interest held by senior/key personnel participating in Beth Israel Deaconess Medical Center research projects funded by the Public Health Service. This information is made available to the public as provided in 42 C.F.R 50.605(a)(5).

Please complete the form below and click "Done." Your response will be sent to the Office of Conflicts and Industry Interactions at BIDMC.