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Forms & requests

Conflict of interest disclosure

Disclosing isn’t an admission of anything. It lets leadership help you manage a relationship before it becomes a problem. Disclose any time something new comes up, not just at your annual review.

Demo runs treatment programs and sober living, so federal law (EKRA and the Anti-Kickback Statute) bans paying for or receiving anything of value for client referrals. That includes relationships with recovery residences, treatment programs, and labs. When in doubt, disclose.

No client names or identifying details. For a client relationship, describe it only, e.g. “a current IOP client is my neighbor.”

Only leadership sees disclosures. Your supervisor isn’t copied.