Submit Institutional Certification

Submit Certification

Submitting the certification is a two step process.
Step 1 - Enter the information about your institution and authorized representative below and then click the "Submit" button. When the submit button is clicked an email will be sent to the email address that is entered below.
Step 2 - Verify the certification. When you receive the email from step 1, click on the link that is contained in the email to complete the verification.

NOTE: Ony records with completed verifications will be valid and thus listed as having certified compliance.

Institution Name
Authorized Representative First Name
Authorized Representative Last Name
Authorized Representative Title
Authorized Representative Email Address
Reenter Email Address
Primary DUNS Number Optional

	I certify that my institution (entity) has an enforced institutional policy implementing the PHS Financial Conflict of Interest Regulations
	I certify that I am authorized to make such certification on behalf of my institution.