Contents & Topics
Related Information
Collaborative Efforts
The Atlanta Research & Education Foundation is designed to facilitate collaborations between the Department of Veterans Affairs Medical Center in Atlanta and other institutions. We welcome your interest in our facility, personnel, and research capabilities.

Working with the larger research community, AREF is one of the leading foundations in the country devoted to improving research, education, and ultimately healthcare for our nation's Veteran population.
Read More

Forms


Atlanta VA Research & Development Forms

Microsoft Word icon Abstract Requirements
Online icon Assessment of Clinical Impact
Microsoft Word icon Assessment of Pharmacy Impact
Adobe Acrobat icon Codes and Instructions for Page 18 (New Investigators Only)
Adobe Acrobat icon Criteria for Reviewing R&D Grants
Microsoft Word icon Extra-VA Funding Submission Approval
Adobe Acrobat icon Financial Conflict of Interest Statement
Adobe Acrobat icon Funding Source Codes
Microsoft Word icon Guidelines for Submission
Microsoft Word icon Investigational Drug Information Record (VA Form 10-9012)
Adobe Acrobat icon Investigator Data Sheet (Page 18) (New Investigators Only)
Microsoft Word icon Manuscript and Abstract Approval
Adobe Acrobat icon MESH Terms for 2002 (1.3M)
Adobe Acrobat icon Personal Data Sheet (New Investigators Only)
Microsoft Word icon RD Protocol Guidelines
Microsoft Word icon Request to Review Research Proposal
Microsoft Word icon Research Approval Outline

Data Security Forms

Microsoft Word icon Attachment C - DTA Within VHA
Microsoft Word icon Attachment D - DTA Outside VHA
Microsoft Word icon Data Authorization Form
Microsoft Word icon Data Security Checklist
Microsoft Word icon Memorandum of Understanding

Emory University IRB Forms

Online icon Emory IRB Submission Forms (External Website)
Online icon Request for Approval of HIPAA Privacy Rule Waiver/Alteration of Patient Authorization (ver. 7/10/2008)
Online icon VA Reportable Event Form (ver. 8-27-09)
Online icon Waiver of Documentation (signature) Requirement of Informed Consent Worksheet (ver. 10-1-09)
Online icon Waiver of One or More Elements of Informed Consent Worksheet (ver. 10-1-09)

Institutional Animal Care & Use Committee (IACUC) Forms

Online icon ACORP (VA Animal Protocol) (Required for all VA-Funded Projects)
Microsoft Word icon Atlanta VA Appendix 9: Breeding Protocol
Online icon Emory Animal Forms (External Website)
Microsoft Word icon Modification Form
Microsoft Word icon Occupational Health & Safety Form
Microsoft Word icon Veterinary Consultation Form (Rich Text Format)

Radiation Safety Forms

Microsoft Word icon Application for the Use of Radioisotopes (New Investigators Only)
Microsoft Word icon Radiation Safety Form For Proposals
Microsoft Word icon Suggested Risk(s) Language for use in Informed Consents

Research Regulatory Binder

Microsoft Word icon IRB Submission Tracking Log
Microsoft Word icon Protocol Amendment/Modification Log
Microsoft Word icon Protocol Deviation Log
Microsoft Word icon Protocol Version Tracking Log
Microsoft Word icon R&D Submission Tracking Log
Microsoft Word icon Record of Approved Consent Forms
Microsoft Powerpoint icon Regulatory Binder Cover
Microsoft Word icon Regulatory Binder Instructions
Microsoft Word icon Reportable Protocol Events
Microsoft Word icon Research Staff Training Log
Microsoft Word icon Safety Report Log
Microsoft Word icon Signatures and Delegated Responsibilities
Microsoft Word icon Study Subject Log

Training

Microsoft Word icon LIBREX Web Site Instructions
Microsoft Word icon LMS Instructions

VA Biosafety Forms

Microsoft Word icon Chemical Inventory Form
Online icon Employee Risk Assessment Form (AREF Online)
Online icon Online LASIF (AREF Online)
Microsoft Word icon Project Modification Form
Microsoft Word icon Request to Review Biosafety Project

VA Career Development Forms

Microsoft Word icon VA Form 10-1313-1
Microsoft Word icon VA Form 10-1313-2
Microsoft Word icon VA Form 10-1313-3
Microsoft Word icon VA Form 10-1313-4
Microsoft Word icon VA Form 10-1313-56
Microsoft Word icon VA Form 10-1313-7
Microsoft Word icon VA Form 10-1313-8

VA Clinical Studies Center Forms

Microsoft Word icon Recruitment Guidelines
Microsoft Word icon VA Informed Consent Form Template (eIRB stamping template)
Microsoft Word icon VA Informed Consent Template Form (Paper Form)
Adobe Acrobat icon Consent for Use of Picture VA FORM 10-3203
Microsoft Word icon VA HIPAA Authorization Template (eIRB)
Microsoft Word icon VA HIPAA Authorization Template (Paper Form)
Microsoft Word icon VA HIPAA Revocation Letter Template (eIRB)
Microsoft Word icon VA HIPAA Revocation Letter Template (Paper Form)
Microsoft Word icon Suggested Risk(s) Language for use in Informed Consents
Microsoft Word icon Research Documents Scanning Request Form
Microsoft Word icon Procedures for Scanning Research Documents
Adobe Acrobat icon HIPAA Privacy Notice
Adobe Acrobat icon HIPAA Guidelines
Microsoft Word icon Essential Things to do Before, During & After Human Research Studies
Microsoft Word icon Research Clinic Profile
Microsoft Word icon Research Clinic Encounter Data Form
Microsoft Word icon FAX Template Investigational Drug Orders
Microsoft Word icon Medical Data Request
Microsoft Word icon Medical Record Flag Waiver Request
Adobe Acrobat icon VA Lab Certification
Adobe Acrobat icon VA Lab CLIA Certification
Microsoft Word icon Research Records Storage Request
Microsoft Word icon Monitoring Visit Report - Entrance Briefing
Microsoft Word icon Monitoring Visit Report - Exit Briefing
Microsoft Word icon Quality Assurance/Improvement Assessment Form (Human Research Studies)
Microsoft Word icon Quality Assurance/Improvement Assessment Form (Investigational Product Research Studies)
Microsoft Word icon Scope of Practice
Microsoft Excel icon CSC Room Request
Microsoft Word icon Investigational Device Accountability Log
Microsoft Powerpoint icon Requirements for Trainees Engaging in Research at the VA

VA Clinical Studies Center Policies & Procedures

Microsoft Word icon Entering Notes in CPRS
Microsoft Word icon PIs Instructions to Order Investigational Drugs in CPRS
Microsoft Word icon Research Coordinators Instructions for Placing Orders in CPRS for Investigational Drugs
Microsoft Word icon Procedures to Post, Remove & Edit Research Flags In CPRS

VA Merit Templates

Microsoft Word icon SF424R-R Biosketch
Microsoft Word icon SF424R-R Biosketch Sample
Microsoft Word icon VA Intro
Microsoft Word icon VA Research Plan
Microsoft Word icon VA Prog_Report Pubs
Microsoft Word icon VA Human Subjects
Microsoft Word icon VA Animals
Microsoft Word icon VA Multiple PIs
Microsoft Word icon VA Agreements
Microsoft Word icon VA Checklist
Microsoft Word icon VA Appendix 1
Microsoft Word icon VA Appendix 2
Microsoft Word icon VA Appendix 3
Copyright © 2010 AREF. All Rights Reserved.     Privacy Statement      Webmaster