ICMJE Form for Disclosure of Potential Conflicts of Interest - LWW.com 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section 1, 'Identifying Information.' Fill in your given name, surname, date, and indicate if you are the corresponding author. Ensure accuracy as this information is crucial.
3. Move to Section 2, 'The Work Under Consideration for Publication.' Answer whether you or your institution received any payment or services from a third party related to the submitted work. Select 'Yes' or 'No' accordingly.
4. In Section 3, disclose any relevant financial activities outside the submitted work. Use the provided table to report relationships with entities over the past 36 months. Click 'Add +' to include additional entries as needed.
5. Proceed to Section 4 regarding Intellectual Property. Indicate if you have any patents relevant to your work and provide details if applicable.
6. In Section 5, report any other relationships that could influence your work. Be transparent about all affiliations.
7. Finally, review your entries in Section 6 where a disclosure statement will be generated based on your inputs. Ensure everything is accurate before submission.

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