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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.
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Forms

Atlanta VA Research & Development Forms

Microsoft Word icon Research Project Approval Process (eRRRP Submissions)
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
Adobe Acrobat icon Financial Conflict of Interest Statement
Adobe Acrobat icon Funding Source Codes
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

Data Security Forms

Microsoft Word icon Attachment C - DTA Within VHA
Microsoft Word icon Attachment D - DTA Outside VHA
Microsoft Word icon Authority to Transport Data
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)
Microsoft Word icon VA Reportable Event Form
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)

VA Human/Clinical Studies Forms

Microsoft Word icon Recruitment Guidelines
Microsoft Word icon VA Informed Consent Form Template (eIRB stamping template)
Microsoft Word icon VA Informed Consent Form Template (eIRB stamping template) - Tracked Changes
Microsoft Word icon VA Informed Consent Template Form (Paper Form)
Microsoft Word icon VA Informed Consent Template Form (Paper Form) - Tracked Changes
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 (eIRB)- TRACKED CHANGES
Microsoft Word icon VA HIPAA Authorization Template (Paper Form)
Microsoft Word icon VA HIPAA Authorization Template (Paper Form)- TRACKED CHANGES
Microsoft Word icon VA HIPAA Revocation Letter Template (eIRB)
Microsoft Word icon VA HIPAA Revocation Letter Template (Paper Form)
Microsoft Word icon Suggested Radiation 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 VA Notice of Privacy Practices (NOPP)
Adobe Acrobat icon NOPP Acknowledgement Form
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 Record Flag Waiver Request
Adobe Acrobat icon VA Lab CLIA Certification
Adobe Acrobat icon CAP expires 2013
Microsoft Word icon Research Records Retention & Storage (Long Term)
Microsoft Word icon Research Records Retention & Storage (Short Term)
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 Word icon VHA Privacy Policy Instructions for Monitors

Institutional Animal Care & Use Committee (IACUC) Forms

Microsoft Word icon Modification Form
Microsoft Word icon Occupational Health & Safety Form
Microsoft Word icon Veterinary Consultation Form (Rich Text Format)
Microsoft Word icon ACORP form for all VA IACUC submissions (Start with this form)
Microsoft Word icon Appendix 1 – required form for housing animals at locations other than the VA
Microsoft Word icon Appendix 2 – required when producing Antibodies using animals
Microsoft Word icon Appendix 3 – required when using test substances (drugs, other agents) in animals
Microsoft Word icon Appendix 4 – required when blood or tissue samples are collected from animals
Microsoft Word icon Appendix 5 – required when major survival surgery is being conducted on animals
Microsoft Word icon Appendix 6 - required when special husbandry or other procedures are required for animals
Microsoft Word icon Appendix 7 – required when animals are being transported through patient areas of the hospital
Microsoft Word icon Appendix 8 – required when explosive agents (i.e. anesthesia such as ether) are being used with animals
Microsoft Word icon Atlanta VA Appendix 9: Breeding Protocol

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 Radiation Risk(s) Language for use in Informed Consents

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 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
Microsoft Word icon VA Form 10-1313-56

VA RFAs

Adobe Acrobat icon HSR&D Merit Review Award (Parent I01)
Adobe Acrobat icon VA Nursing Research Initiative (NRI)
Adobe Acrobat icon HSR&D Merit Review Award for Traumatic Brain Injury (TBI) Research
Adobe Acrobat icon HSR&D Merit Review Award for Deployment Health Research (OEF/OIF/OND)
Adobe Acrobat icon HSR&D Merit Review Award for Parkinson's Disease and Related Neurodegenerative Disorders
Adobe Acrobat icon HSR&D Career Development Award (CDA-1)
Adobe Acrobat icon HSR&D Merit Review Award for Research Best Practices (RBP)
Adobe Acrobat icon HSR&D Targeted Solicitation for Research Projects on Caregiver Programs and Practice to Improve Care Delivery for Veterans
Adobe Acrobat icon HSR&D Targeted Solicitation for Projects Customizing Long Term Care Programs and Practice to Meet Veterans' Needs in the 21st Century
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