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Conflict of Interest & Confidentiality Declaration Form.

Completing this declaration is an annual requirement.

Reference: U-L5-P01: Our Culture: Equality, Diversity & ‘Speak Up’ (Whistleblowing) Policy (COI Procedure)

About this declaration

To ensure Unbound Living operates with integrity, all staff must identify and declare any personal, professional, or financial interests that could influence, or be seen to influence, their professional judgement.
What is a conflict of interest?
A conflict exists if your personal interests (or those of a close family member or friend) compete with your duties at Unbound.
Common examples • Holding shares in, or working for, a supplier, partner, or competitor of Unbound • Being involved in hiring or procurement decisions affecting a family member or friend • Accepting gifts or hospitality from a current or prospective supplier • Outside clinical, consultancy, or advisory work that overlaps with Unbound's services

Your details

Full name

Your role at Unbound

Type of declaration

A
B
C

Declarations of interest

If you answer "Yes" to any question, please give details in the box that follows.

Financial interests

Do you (or a close family member) hold any financial interest, shares, or ownership in a company that competes with Unbound or supplies services to us (e.g., Labs, Tech Providers, Wellness Brands)?
A
B

If yes, please give details

Name of the company, nature of the interest (e.g., shareholding, ownership, family member's role) and approximate value or percentage held.

Professional interests & outside employment

Do you hold any other employment, consultancy, or directorships outside of Unbound that could impact your ability to perform your role or create a conflict of loyalty?
A
B

If yes, please give details

Organisation, your role, time commitment and whether it is paid.

Personal relationships

Do you have any personal relationships with current Unbound suppliers, partners, or key service users that could influence business decisions (e.g., hiring, procurement)?
A
B

If yes, please give details

Who the relationship is with, the nature of the relationship, and which decisions it could affect.

Gifts & hospitality

Have you received any gifts, hospitality, or benefits (valued >£50) from a third party related to your work at Unbound in the last 12 months that have not already been declared?
A
B

If yes, please give details

What was received, from whom, approximate value, and date received.

Confidentiality undertaking

Unbound Living entrusts you with sensitive information regarding members, commercial strategy, and clinical data. By agreeing below, you undertake to:
• Keep all member, clinical, and commercial information confidential, both during and after your time with Unbound. • Access and use information only as needed for your role, in line with UK GDPR and Unbound's data protection policies. • Not disclose confidential information to anyone outside Unbound without proper authorisation. • Report any actual or suspected breach of confidentiality immediately.

Do you agree to these terms?

Declaration

Declaration statement

Signature

Signature

Date