Forms

For your convenience, we have created editable versions of these forms in PDF and Word. If you have questions about which to use, please contact your local AO or the ORD Central Office representative for your particular research service. If using a PDF version, please review the important information below.

If you have questions about these forms and the upcoming round of funding applications and submissions, please refer back to the Application & Submission page.

Number

Title

Editable

10-0102

Career Development Application

PDF

10-0398

Research Protocol Safety Survey

PDF

10-0436

Application for an Off-Site Tissue Banking Waiver

PDF

10-0455

Clinical Trial Annual Progress Report

PDF

10-0456

Clinical Trial Inclusion/Enrollment Report

PDF

10-1086

Research Consent Form

MSWord PDF

10-1223

Report of Subcommittee on Human Studies

MSWord PDF

10-1313-1

Merit Review Application

MSWord PDF

10-1313-2

Research & Development Program

MSWord PDF

10-1313-3

R&D Program - Current Funds & First Year Request

MSWord PDF

10-1313-4

R&D Program Estimated

MSWord PDF

10-1313-5

R&D Program - Investigator's Biographic Sketch

MSWord PDF

10-1313-5/6

Combined Biographical Form

MSWord PDF

10-1313-6

R&D Program - Investigator's Bibliography

MSWord PDF

10-1313-7

R&D Program - Investigator's VA & Non-VA Research/Dev. Support

MSWord PDF

10-1313-8

R&D Program - Investigator's Total VA & Non-VA Research/Dev. Support

MSWord PDF

10-1313-10

Research Advisory Group Summary Statement

MSWord PDF

10-1313-11

Rehab. R&D Svc. - Scientific Merit Review Board Summary Statement

MSWord PDF

10-1313-13

VHA R&D LOI Cover Page Form

PDF

10-1314

HSR&D Career Development Awardee Annual Progress Report

MSWord PDF

10-1436

R&D Information System Project Data Sheet

MSWord PDF

10-9012

Investigational Drug Information Record

PDF

3963

Position Report

MSWord PDF

4670

Position Classification Worksheet for Research Positions

MSWord PDF

 

Additional Information

Other research-related forms are available online from VHA’s database of electronic forms. You may search the database by form number or keyword. Try entering "research" in the title/keyword field to locate research-related forms.

Please email the R&D Web Team if you have any questions.


**Important PDF Information:
If you open the PDF forms and they appear as a blank pages the likely cause is that the old version of Adobe Acrobat Reader is installed on your computer. If you have Adobe version 5.0.0, you must upgrade to Acrobat Reader version 5.0.5 or newer to view and print the forms. You can download the free software at Adobe Acrobat Reader.

The functionality of the editable PDF forms may be limited depending on the product you are using.

  • If you have the free Adobe Acrobat Reader software you can fill the forms out and print them, you cannot save them. You must re-fill the pdf form everytime you open it. The Adobe Acrobat Reader software functions this way by design, it is supposed to allow users to view PDF files, it is not designed to edit them.
  • In order to be able to complete, save and print the editable forms, you will need to have the full Adobe Acrobat package.