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James A. Haley Veterans' Hospital
Research Procedures, Forms, and Templates

Research Forms and Templates

All forms must be typewritten.
Be sure to dowload the latest version here before you begin completing a form.

  Accelerated Review Application

  Biosafety Form (Research Protocol Safety Survey)

  Biosafety Annual Update

  Biosafety Reviewer Checklist

  Code of Ethics Form

  Continuing Review

  Core Values

  Credentialing Verification Form

  Data Security Checklist & Certification

  Data Transfer Agreement / ISO

  Disclosure of Investigator Interests

  Extra-VA Sponsors

  Frequently Asked Questions (FAQs)

  Flow Chart for Protocol/Form Submission

  Guidelines for Preparing a Research Protocol

  Intellectual Property Agreement for Without Compensation Appointment (WOC)

  Investigational Drug Information

  Investigator Checklist

  Investigator Data Sheet


Informed Consent Templates

  • This informed consent format must be used for all research studies conducted at James A. Haley VAMC.
  • For VA research this consent document must be signed and dated by the research subject.
  • The consent document must also be signed and dated by a witness to the signature of the research subject.
  • The research document must also be signed and dated by the person obtaining consent.
  • A copy of the signed and dated consent document must be provided to the research subject.

  Informed Consent - Medical

  Informed Consent - Social

  Informed Consent for Proxy - Medical

  Informed Consent for Proxy - Social


  Investigator Data Sheet - Codes

  Just-In-Time Submission

  Key Personnel Form

  Letters of Concurrence RSOP-29 - Memo, Investigator Checklist, Privacy Review Checklist

  Minimal Risk Submission Checklist

  Monitor Checklist

  Monitor Outcome Report

  Orientation Manual for Clinical Coordinators

  Patents - Rights & Responsibilities

  Personal Data on VA Investigators

  Privacy Practices, Notice of

  Privacy Review Checklist

  Protocol Information

  R & D Submission Checklist - Full Board Review

  R & D Committee Protocol Evaluation Form

  Release of Information

  Report of Subcommittee on Human Studies

  Request to Review Research Proposal/Project

  Request to Review Research Proposal - Funding Codes

  Request to Review Research Proposal/Project - Instructions

  Review of Reports of Unanticipated Problems or Adverse Events RSOP-10

  Review of Research Proposal - Just in Time

  Safety Review Checklist - Full Board

  Safety Review Checklist - Amendment

  Safety Review Checklist - Just in Time

  Select Agents and Toxins List

  Serious Adverse Event Statement

  Technology Transfer Program Certification

  Training Requirements for Non-VA Personnel

If you have any questions or comments about VA forms or procedures, please contact
Sandra Thomas, R.N., at (813) 972-2000 ext. 7872 or sandra.thomas4@va.gov
If you have any trouble downloading from this page, please contact
John Arnaldi (813) 974-7363 jarnaldi@research.usf.edu

Division of Research Integrity & Compliance
Mail: 12901 Bruce B. Downs Blvd, MDC35, Tampa, FL 33612-4799   Phone: (813) 974-5638  Fax: (813) 974-5618

Copyright © 2008, University of South Florida. All rights reserved.

Direct questions or comments about this Web site to jarnaldi@research.usf.edu  Last updated: May 6, 2008