General Research Forms and Information - VA Pittsburgh Healthcare System
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General Research Forms and Information

This page contains a comprehensive list of research forms that may be needed. Forms are categorized by the type research to which they are applicable. Forms that are applicable to more than one type of research are listed under the heading of General Research Forms. Please note that all forms specific to Human Subjects Research are accessible via ProSPECT.

Animal Forms

Animal Budget Form

Animal Exposure Preventive Medicine Program (AEPMP): Annual Review Form

Animal Exposure Preventive Medicine Program (AEPMP): Initial Exam Form

Animal Exposure Preventive Medicine Program (AEPMP): Declination Form

Animal Exposure Preventive Medicine Program (AEPMP): Vets/Non-affiliated Members of the IACUC

Animal Exposure Preventive Medicine Program (AEPMP): Non-Research Personnel

Animal Protocol (ACORP) Amendment Request Form

Animal Research Study Incident Report Template

Breeding Supplement

IACUC Research Project Study Closure Form

Letter of Support IDS


Protocol to Protocol Animal Transfer Form

Employment, Training and Credentialing Forms

Applicant's Statement of Service Registration Status

Education Verification

Form 1-9 (Employment Eligibility Verification)

Form OF-306 (Declaration for Federal Employment)

Form SF61 (Appointment Affidavits)

Intellectual Property Agreement

Policy Prohibiting Patient Abuse

General Research Forms

Chemical, Bio, Gas Supply Request Form

Conflict of Interest Statement for Committee Members

Funding Source Codes

Guidance on Written Agreements

IBC Amendment Request Form

Incoming Materials Transfer Agreement (MTA) Form

Letter of Support from Service Lines Template

Memorandum of Understanding (MOU) Template

Non-Financial Conflict of Interest Statement

Non-Financial COI Policy

Non-VA Research Contribution Form

Non-VAPHS Research Advertisement Request Form

Notification of Publication/Presentation/Recognition of Research Results

Outgoing Materials Transfer Agreement (MTA) Form

Part I: Request to Conduct Research

Privacy and Data Security Plan

Request for Research Records Storage

Research Financial Conflict of Interest Statement

Research Network Rules of Behavior

Research Office Building Conference Room Scheduling

Research Scope of Practice

Research Staff Form

Research Supply Request Form

Research WOC Credentialing and Privileging Form

Storage and Retrieval Worksheet

University Administered Research Memo

VA Form 10-5386/Investigator Data Sheet (page 18)

VAPHS Administration of Extramural Grants Policy

VAPHS Research Data Management and Access Plan (DMAP) Policy

VAPHS Research Data Use Agreement


VAPHS Research Information Protection Program Policy

VAPHS Research Written Agreement

Radiation Safety Forms

Application for Personal Radiation Monitoring Device

Authorization to Purchase or Use Radiation Generating Equipment

Form Letter for Declaration of Pregnancy

Part V: Application to Use Radioactive Materials

Radioactive Spill Report

VAPHS Record for Radioactive Waste Disposal

Research Safety and Security Forms

Application to Access Research Secured Area

Request for Staff Access to Research Secured Area

Biosafety Level 2 (BSL-2) Procedure Template

Chemical Matrix

Hazardous/Select Agent Certification Form

Part II: Research Protocol Safety Survey 

Part II Attachment A: Definition of Hazards

Part II: Attachment B: Description of Biosafety Levels (BSL)

Part II: Attachment C: Biological Safety Cabinets

Part II: Attachment D: Listing of Common Controlled Substances

Personal Protective Equipment (PPE) Hazard Assessment Certification Form

Research Safety Incident Report Template

Research Scientific Evaluation Committee (RSEC) Forms

RSEC Research Project Closure Form

Pre-submission and Administrative Review of Application for Research Funding