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ICMJE Form for Disclosure of Potential Conflicts of Interest - acponline 2026

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The document is the ICMJE Form for Disclosure of Potential Conflicts of Interest, which requires authors to disclose any financial relationships or interests that may influence their manuscript. It consists of four sections: identifying information, details about the work under consideration, relevant financial activities outside the submitted work, and other relationships that could be perceived as conflicts of interest. Each author must complete a separate form to ensure transparency regarding potential influences on their research.

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Click ‘Get Form’ to open it in the editor.
Begin with Section 1: Identifying Information. Enter your full name, check if you are the corresponding author, and provide the manuscript title and identifying number.
Move to Section 2: The Work Under Consideration for Publication. Indicate whether you or your institution received any third-party support for the work. Check 'Yes' or 'No' and fill in details as required.
Proceed to Section 3: Relevant Financial Activities Outside the Submitted Work. Report any financial relationships with entities that could influence your work, using one line per entity and adding rows as necessary.
Finally, complete Section 4: Other Relationships. Disclose any additional relationships that may be perceived as influencing your work.

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What is a conflict of interest disclosure form?

The ICMJE recommends that an author should meet all four of the following criteria:Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work,Drafting the work or revising it critically for important intellectual content, Final

What is the Icmje disclosure form?

ICMJE DISCLOSURE FORM Guidance and definitions: This form is to enable you to provide information about financial and non-financial relationships and activities that readers may find pertinent to your work.

What are the 4 criteria for the Icmje?

The International Committee of Medical Journal Editors (ICMJE) is a group of general medical journal editors meeting regularly and works on Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals (.ICMJE.org).

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