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    Coi disclosure-SA

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    Antonio
    This document is an ICMJE disclosure form completed by Dr. Sanjay Agarwala for a manuscript titled "Restoring post-COVID Hips – Medical Management of a Surgical Condition". The form asks the author to disclose any relationships or activities in the past 36 months related to the content of the manuscript. Dr. Agarwala indicates that he has no relationships, activities, grants, payments, stock, or other interests to disclose for this manuscript.

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    Coi disclosure-SA

    Uploaded by

    Antonio
    29 views2 pages
    This document is an ICMJE disclosure form completed by Dr. Sanjay Agarwala for a manuscript titled "Restoring post-COVID Hips – Medical Management of a Surgical Condition". The form asks the author to disclose any relationships or activities in the past 36 months related to the content of the manuscript. Dr. Agarwala indicates that he has no relationships, activities, grants, payments, stock, or other interests to disclose for this manuscript.

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    This document is an ICMJE disclosure form completed by Dr. Sanjay Agarwala for a manuscript titled "Restoring post-COVID Hips – Medical Management of a Surgical Condition". The form asks the author to disclose any relationships or activities in the past 36 months related to the content of the manuscript. Dr. Agarwala indicates that he has no relationships, activities, grants, payments, stock, or other interests to disclose for this manuscript.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    29 views2 pages

    Coi disclosure-SA

    Uploaded by

    Antonio
    This document is an ICMJE disclosure form completed by Dr. Sanjay Agarwala for a manuscript titled "Restoring post-COVID Hips – Medical Management of a Surgical Condition". The form asks the author to disclose any relationships or activities in the past 36 months related to the content of the manuscript. Dr. Agarwala indicates that he has no relationships, activities, grants, payments, stock, or other interests to disclose for this manuscript.

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    © All Rights Reserved
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    ICMJE DISCLOSURE FORM

    Date: 10-05-2022
    Your Name: Dr. Sanjay Agarwala
    Manuscript Title: Restoring post-COVID Hips – Medical Management of a Surgical Condition
    Manuscript number (if known):__________________________________________________________________

    In the interest of transparency, we ask you to disclose all relationships/activities/interests listed below that are
    related to the content of your manuscript. “Related” means any relation with for-profit or not-for-profit third
    parties whose interests may be affected by the content of the manuscript. Disclosure represents a commitment
    to transparency and does not necessarily indicate a bias. If you are in doubt about whether to list a
    relationship/activity/interest, it is preferable that you do so.

    The following questions apply to the author’s relationships/activities/interests as they relate to the current
    manuscript only.

    The author’s relationships/activities/interests should be defined broadly. For example, if your manuscript pertains
    to the epidemiology of hypertension, you should declare all relationships with manufacturers of antihypertensive
    medication, even if that medication is not mentioned in the manuscript.

    In item #1 below, report all support for the work reported in this manuscript without time limit. For all other items,
    the time frame for disclosure is the past 36 months.

    Name all entities with Specifications/Comments


    whom you have this (e.g., if payments were made to you or to your
    relationship or indicate institution)
    none (add rows as
    needed)
    Time frame: Since the initial planning of the work
    1 All support for the present None
    manuscript (e.g., funding,
    provision of study materials,
    medical writing, article
    processing charges, etc.)
    No time limit for this item.

    Time frame: past 36 months


    2 Grants or contracts from None
    any entity (if not indicated
    in item #1 above).
    3 Royalties or licenses None
    4 Consulting fees None

    5 Payment or honoraria for None


    lectures, presentations,
    speakers bureaus,
    manuscript writing or
    educational events
    6 Payment for expert None
    testimony

    7 Support for attending None


    meetings and/or travel

    8 Patents planned, issued or None


    pending

    9 Participation on a Data None


    Safety Monitoring Board or
    Advisory Board

    10 Leadership or fiduciary role None


    in other board, society,
    committee or advocacy
    group, paid or unpaid
    11 Stock or stock options None

    12 Receipt of equipment, None


    materials, drugs, medical
    writing, gifts or other
    services
    13 Other financial or non- None
    financial interests

    Please place an “X” next to the following statement to indicate your agreement:

    X I certify that I have answered every question and have not altered the wording of any of the questions on this
    form.

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