South Florida VA Foundation for Research & Education

All Forms

     Admission of Non-Veterans  (Jan 1992)           (Word)          (PDF)

     Adverse Event Reporting Forms:

          Tracking Log for Non Reportable Event (05/02/08)          (Word)     

          Unanticipated Problems Form (05/06/08)                        (Word) 

     Amendment to Research (05/06/08)                 (Word)

     Amendment to Recruitment Plan (5-28-07)      (Word)

     Animal Amendment Review Form  (1/08)        (Word) 

     Application for Miami VA Research Project                   (Word)      (PDF)

     Applications for Health Benefits  10-10EZ                       (Word)

     Application for Human Research Project  (05/22/08)      (Word)     

     Biohazard/Chemical Hazard Information Form for Research        (Word)          (PDF)

     Biohazard Use Form  (1/08)                             (Word)     

     Biological Sample Statement  (9/9/02)            (Word)

     Decisional Capacity and Surrogate Consent   (Word)

     Dietetic Service Request                                 (Word)

     Disclosure of Available Funds  (05/22/08)         (Word)

     Disclosure of Financial Interests - Conflict of Interest  (05/22/08)    (Word)

     Extra-VA funds memorandum (12/10/2003)      (PDF)

     Exempt Research Request Form (05/06/08)     (Word)

     Expedited Review Request Form (05/06/08)    (Word)

     FDA-1571 - Investigational New Drug Application  (Exp 5/31/09)      (Word)

     FDA-1572 - Statement of Investigator  (Exp 5/31/09)                         (Word)

     HIPAA Guidance Document  (6/1/04)            (Word)

     Informed Consent - Blank  (4/26/04)             (Word)

     Informed Consent Compliance Checklist    (Word)  

     Informed Consent - Spanish  (4/26/04)         (Word)  

     Informed Consent - Example  (11/6/07)         (Word)

     Informed Consent Preparation - Investigator Checklist  (05/13/08)    (Word)

     Investigational Drug Record  10-9012  (Sept 1998)            (Word)

     Location of Research  (05/27/08)            (Word)

     Merit Review Forms:

                         Please Contact Research Office

                         at x3179 for assistance in Merit Review Submissions.

     Project Data Sheet 10-1436  (Jun 1989)                                               (Word)          (PDF)

     Radioactive Materials  (Aug 1997)                                                       (Word)

     Report of Research Staff Members  (6/5/07)                                         (Word)

     Resident Scholarly Activity Program - Application (4/8/03)                  (Word)

     Scope of Practice for Research Staff                                                  (Word)

     Waiver of Documentation of Informed Consent Request Form (6/5/07)     (Word)

     Waiver of IC and HIPAA Waiver of Authorization (Now Combined)     (Word)   

     Waiver of IND Request                                                                        (Word)

     Foundation Employee Forms      

           Meeting (Business) Expenditures Form                        (PDF)

           Meeting (R&E) Expenditures Form                               (PDF)

           Non-Travel Reimbursement Request Form                  (PDF)

           Overtime Request Form                                               (PDF)

           Payroll Calendar                                                          (PDF)

           PO Request Form                                                         (PDF)

           Subscription Payment Request Form                           (PDF)

           Time Sheet                                                                   (PDF)

           Travel Request Form                                                    (PDF)

           Travel Voucher - Reimbursement Form                        (PDF)

           PI Hiring Information Form                                          (PDF)