Conflict of Interest Declaration

UKATA Conflict of Interest Declaration

To be completed by council, staff, subcommittees, chairs, reps

CONFIDENTIAL Council/Subcommittee Information relationships (details below will be kept confidentially with the UKATA Office and Chair)

Your Name

UKATA Role

Status

Client

Therapist

Supervisor/ee

Trainer/ee

Family member

Names

Date

Month

Day

Year

Public details (details below will be published on the members site)

Your Name

Type of role in UKATA

Status/modality

Core Training establishment

Current training links

Dual Roles

Business interests

CoI

Date

Month

Day

Year

Conflict of Interest Declaration