2025 EASL DECLARATION OF INTERESTS (DOI) FORM EASL Governing Board, Committees, Task forces, Editorial Teams, Event organising committees and faculty, members of EASL Clinical Practice Guidelines panels, Ethics and Compliance Committee and EASL staff The EASL Code of Conduct is designed to ensure EASL’s balance, independence, objectivity, and scientific rigour in all its scientific, educational and advocacy programmes. The EASL Code of Conduct requires all EASL Stakeholders (EASL Governing Board, Committees, Task forces, Editorial Teams, Event organising committees and faculty, members of EASL Clinical Practice Guidelines panels, Ethics and Compliance Committee and EASL staff) to submit a DOI Form before any hire/appointment is made or work is carried out or conducted. The DOI form must be updated yearly or when necessary. Stakeholders use the form to disclose any financial or beneficial relationships with a commercial interest that could be viewed as presenting a potential conflict of interest, and must declare any relationship that may lead to a potential commercial bias as outlined in the EASL Code of Conduct. You are asked to review the EASL Code of Conduct prior to completing this form. Stakeholders must also declare relevant interests of their Family Members (1st line) as defined in the EASL Code of Conduct. The Declaration of Interests (DOI) forms of the Secretary General, Vice-Secretary, as well as Editors-in-Chief will be published on EASL website, in the Ethics and Compliance section, and the forms of the other members of the Governing Board and Committees will be available upon request. This DOI Form shall be completed within the context of the EASL role OR office, i.e. the type of role envisaged. DEFINITIONS REVIEW Company: A Company is an entity that develops, produces, markets, or distributes drugs, devices, services or therapies used to diagnose, treat, monitor, manage, and alleviate health conditions and whose interests could reasonably be seen to overlap with the interests, missions and values of EASL. Organisation: a governmental, international, or non-profit organisation. Direct Financial Relationship: refers to either: (i) monetary value, such as equity interests, including stock or stock options, or other ownership rights and dividends tied thereto; (ii) intellectual property rights such as patents, copyrights and royalties; (iii) payments for services, including from one-offs and part-time roles such as speaking engagements and advisory board memberships. Indirect Financial Interest: refers to a situation where a party stands to benefit from work done by, or decisions made by, the EASL Stakeholders or Third-Party Provider Educational Grant: An Educational Grant is a sum awarded by a Company for the specific purpose of supporting an educational or scientific activity offered by the recipient. An Educational Grant may also be “in-kind.” Gifts “in kind”: Compensation in goods or services rather than money; non-monetary gifts, benefits (for example access to advisory or consultant services, specific resource allocation or access). Research Grant: A Research Grant is an award that is given by a Company or other funding agency to an individual, institution, or practice to fund the conduct of scientific research. Companies may provide an individual, institution, or practice with programmatic support (e.g., an Educational Grant) designated for the specific purpose of funding Research Grants. INSTRUCTIONS FOR COMPLETING THIS FORM In keeping with EASL policies, it is usually better to disclose an activity or relationship than not to do so. The time period for disclosure is the 12 months preceding and including the date of the disclosure. It’s also possible to disclose a future and relevant material change. 1. STAKEHOLDER INFORMATION First name and Last name should be provided as reflected in the EASL Membership Directory. First Name: Last Name: Organisation: Address: Email: EASL role/office: Select an option Author Committee member CPG Panel Member Editor in Chief Editorial Board Executive Director Faculty Governing Board Secretary General Vice-Secretary Staff Treasurer Task Force member Other 2. DISCLOSURE STATEMENT You* should report all relevant sources of revenue paid, or promised to be paid, either directly to you, or to your institution on your behalf, over the preceding 12 months and including the date of the disclosure. *The term "YOU" refers to yourself and your immediate Family Members (1st line). For Grants, disclose support only from entities that are, or might be, defined as a Company. Public funding sources such as government agencies, charitable associations, etc., generally need not be disclosed. However, in the event that a particular relationship with one of these public funding sources might be perceived as creating an actual or potential conflict of interest, disclose the relationship and provide relevant information in the Comments entry. Similarly, any royalties (defined as use-based payments made to you or your institution as the holder of a patent, copyright, registered trademark, or other property) should be disclosed. DISCLOSURE STATEMENT Within the last 12 months, do you have or have you had financial or other relationships / activities that could be perceived to influence or that give appearance of potentially influencing your EASL related activities? Yes No If yes, please complete the following sections according to relationship category / categories that are applicable to you. A. Governing Board Position in related International Society, Association or Foundation Yes (please specify: ) No B. Consultant / Advisor to healthcare sector companies Nothing to declare 1 Organisation / Company name: X Money paid to: You Institution Amount (EUR): below 5,000 below 20,000 20,000 – 50,000 More than 50,000 + Add another C. Employee, Officer, Director in a healthcare sector company Nothing to declare 1 Organisation / Company name: X + Add another D. Employee, Officer, Director or stockholder* in university start-up or spin-off** Nothing to declare 1 Organisation / Company name: X Money paid to: You Institution Amount (EUR): below 10,000 10,000 – 50,000 More than 50,000 + Add another E. Alcohol industry Within the past 5 years, have you had employment, received a fee, received research support, or received any other funding from, or had any other professional relationship with, an entity directly involved in the research, manufacture, distribution or sale of products or provision of services in this industry, or representing the interests of such entity? Yes No F. Food & nutrition industries Within the past 5 years, have you had employment, received a fee, received research support, or received any other funding from, or had any other professional relationship with, an entity directly involved in the research, manufacture, distribution or sale of products or provision of services in this industry, or representing the interests of such entity? Yes No G. Other industries active in EASL subject-matters. Within the past 5 years, have you had employment, received a fee, received research support, or received any other funding from, or had any other professional relationship with, an entity directly involved in the research, manufacture, distribution or sale of products or provision of services in this industry, or representing the interests of such entity? Yes No Comments: H. Speaker or author in educational activities supported by industry for promotional purposes Nothing to declare 1 Organisation / Company name: X Money paid to: You Institution Amount (EUR): below 5,000 5,000 – 10,000 10,000 – 20,000 More than 20,000 + Add another I. Speaker in industry sponsored satellite activities during official EASL meetings Nothing to declare 1 Organisation / Company name: X Money paid to: You Institution Amount (EUR): below 5,000 5,000 – 10,000 + Add another J. Received honoraria and travel for CME accredited events Nothing to declare 1 Organisation / Company name: X Money paid to: You Institution Amount (EUR): below 5,000 5,000 – 10,000 + Add another K. Healthcare company sponsored travel and accommodation to meetings Nothing to declare 1 Organisation / Company name: X Money paid to: You Institution Amount (EUR): below 2,000 2,000 – 5,000 + Add another L. Grants / Research support from healthcare industries Nothing to declare 1 Organisation / Company name: X Money paid to: You Institution Amount (EUR): below 2,000 2,000 – 5,000 + Add another M. Investment interests* Do you have current, or did you have in the past 5 years, investments (e.g., proprietorships, partnerships, joint ventures, board memberships, controlling interest in a company) valued at more than CHF 5,000 overall in a commercial entity with an interest related to the outcome of any projects handled by EASL or that you are advising on? Yes No * Restrictions and disclosure also apply to 1st degree family members N. Intellectual Property Rights and Patents Do you have a current, or did you have in the past 5 years, personal interest in any intellectual property rights (patents, trademarks, or copyrights, including pending applications) that might be enhanced or diminished by any projects being handled by EASL or that it is advising on? Yes No O. Royalties* Nothing to declare 1 Organisation / Company name: X Money paid to: You Institution Amount (EUR): below 10,000 10,000 – 50,000 50,000 – 100,000 More than 100,000 + Add another 3. ADDITIONAL INFORMATION Will your work for EASL enable you to obtain access to a competitor's confidential proprietary information, or give you a personal, professional, financial, or business competitive advantage? Yes No To your knowledge or belief, would the outcome of any work you do for EASL benefit or adversely affect interests of others with whom you have substantial common personal, professional, financial, or business interests (such as Family Members, close professional colleagues, administrative unit or department)? Yes No Is there any other aspect of your background or present circumstances not addressed above that might be perceived as affecting your objectivity or independence? Yes No Additional comments/relationship information: DECLARATION AND SIGNATURE I hereby acknowledge that I have read the EASL Code of Conduct. By submitting this form, I confirm that the information provided is true, accurate and complete to the best of my knowledge. I also acknowledge that this submission serves as my electronic signature. Should there be any change to the above information, I will notify the EASL Ethics and Compliance Committee Chair and describe these changes without delay. Filled and submitted by: (Please enter your first and last name) Date: EASL Ethics & Compliance Committee review and notes (if applicable)
