NSGC Conflict of Interest Complaint Form for Continuing Education Activities

ABGC defines conflict of interest (COI) as a situation in which a financial, professional, and/or personal affiliation has the potential to compromise an educator’s judgment and may potentially bias a person’s ability to objectively plan, implement, or review educational content. A conflict of interest may be actual, potential, or perceived. Potential and perceived conflicts of interest should be treated the same as actual conflicts of interest. 

Allegations of conflict of interest are taken seriously by the National Society of Genetic Counselors. If you believe a conflict of interest violation has occurred at a Category 1 approved activity, you are encouraged to file a complaint to the National Society of Genetic Counselors Continuing Education COI Complaint Review Subcommittee. Your complaint will be reviewed by Continuing Education COI Complaint Review Subcommittee and you will be informed in writing of the outcome of its review and decision.

Please note: you may also indicate commercial bias on a conference or activity’s evaluation forms when completing your post-activity survey, but this does not constitute a formal complaint. Please use this NSGC Category 1 Activity Conflict of Interest Form to file a complaint.

Complaints must be submitted within 60 days of completing an activity, in-person or online.

For questions regarding the conflict of interest policy, please contact ceu@nsgc.org.

Please describe the complaint below:

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* 1. This incident occurred at: 

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* 2. Name of activity

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* 3. Date of Activity Completion

Date

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* 4. Please state the nature of your complaint and include any background information or evidence you wish to be considered by the investigating committee. 

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* 5. Your Contact Information (Your contact information will not be shared with the organization or speaker about whom you are submitting a complaint. NSGC may use your contact information to reach you for further information or context about the complaint you are submitting.)

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* 6. Electronic Signature 

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* 7. Date

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