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VA Research Project Submission Checklist

• States policy of R&D Committee for research approval.
• Gives basic directions for completion of all forms.
• Lists sites where forms can be found.
• Denotes where items should be sent.
• Lists all forms

• VA Form 10-5368
• Department of Veterans Affairs IT format for each new investigator.
  

• VA Form 10-1436
• Department of Veterans Affairs IT format for each new project.

• Specific to Roudebush VAMC to provide additional information to help the Committee determine appropriateness of project for unique population and facility.

• VA Form 10-0436
• Department of Veterans Affairs' application for permission to use a tissue bank outside of the VA.

• VA Form 10-1086
• Department of Veterans Affairs format for Informed Consent with suggested wording taken from the IUPUI RCA’s informed consent template including specific wording for “Research Subject Costs” and a contact number for the VA Customer Service Office.

• VA Form 10-9012
• Department of Veterans Affairs format for providing communication between the PI and VA Pharmacy.
• Requires signed approval by the IRB and R&D Committee chairpersons.

• VA Form 10-0398
• Department of Veterans Affairs format to obtain information pertaining to laboratory practices in “wet labs” at the VA used for research specimens.
• Must be completed for all VA funded research.

• Local form to provide a standard communication tool between the PI and laboratory services.

Memo for Authorization to Transpot VA Sensitive Information