VA Portland Health Care System
Research & Development - Forms and Policies
To access VAIRRS, please click here:https://gov.irbnet.org/release/index.html
IRBManager is in the process of being decommissioned, VAIRRS is the replacement system and is live June 30, 2021.
Proposed Project Questionnaire (33KB, MSWord)
The VA PPQ provides basic information necessary for the VA Research Office to evaluate and route the project. This form must be completed by a VA PI when submitting a study/grant that uses VA resources (i.e., VA time, VA patients, VA space, and/or VA equipment).
Conflict of Interest
Conflict of Interest in Research Form (PDF)
As described in the Proposed Project Questionnaire under the Conflict of Interest section investigators, including all local Principal Investigators (PIs), study chairs, site PIs, co-PIs, co-investigators, and sub-investigators, must complete this form. The completed form(s) must be submitted with the PPQ.
Financial Administrative Review
Financial Administrative Review (183KB, MSWord)
The financial administrative review process identifies those research-related study activities that impact non-research resources of the VA Medical Center. This paperwork is required for all human studies proposals which will use medical center resources such as extra clinic time, MRIs, labs, pharmacy, etc.Be sure to include these research-related costs into budgets for all new studies, regardless of study administrator (OHSU, PVARF, or VA). The costs will be returned to the VA Medical Center once study enrollment begins.
Institutional Review Board (IRB)
The Institutional Review Board (IRB) is the committee charged with protecting people participating in research studies. The forms necessary to submit a project to the IRB for review may be found below. Further IRB information, such as the IRB schedules, rosters, and education links, may be viewed at the VAPORHCS IRB web page.
Determination of IRB Review Forms
IACUC FORMSAnimal Component of Research Protocol (ACORP)
Effective June 30, 2021, all packages requiring IACUC review must be submitted in VAIRRS. Questions regarding what documents need to be submitted or where to find documents can be sent to PVAMC-IACUC@va.gov.
The ACORP should be completed when a VA PI is submitting a study/grant which uses animals AND requests VA funds (i.e., Merit Review, Career Development) AND/OR the VA PI wishes to house the animals at the VA Portland Health Care System's Veterinary Medical Unit (VMU). Visit the VA Office of R&D Animal Documents and Resources web page for further information. Deadline for consideration at the next meeting is the 15th of the month (or the next business day).
NOTE: VA Central Office expects a detailed literature search of alternatives to animal testing with the ACORP submission. See the following document for details: Database Searches for Alternatives to Animal Testing (34KB, MSWord)
A continuing review is required annually prior to the expiration of the approved ACORP. Notices are generated to investigators at least one month prior to expiration. Continuing reviews will be submitted through VAIRRS beginning June 30, 2021.
Amendment to ACORP
The ACORP may be amended to reflect changes in the approved ACORP; for example, personnel changes, addition of animals, drugs or procedures. PLEASE NOTE: As of June 30, 2021, all amendments will be submitted using VAIRRS.
Standard Operating Procedures (SOPs)
These Standard Operating Procedures have been approved by the IACUC and may be referenced in your ACORP. If you intend to reference any of these SOPs in your animal protocol, please add a statement in Item C.2. that you have read and understand the guidelines in the <specific title> SOP and that you will follow the procedure outlined. Additionally, if you would like to propose that a new SOP be reviewed and approved by the IACUC, please contact Margaret Doherty (email@example.com) and Kim Neve (firstname.lastname@example.org) for additional information.
Conditioned Place Preference (or Aversion) Testing SOP (115KB, MSWord)
Effective June 30, 2021, all packages for committee review must be submitted through VAIRRS.
IRB forms for OHSU IRB3 (joint board) studies can be found here: OHSU IRB3 page.
PLEASE NOTE: When selecting forms to use for your submission, you will need to know if your study is under the new Revised Common Rule, also referred to as 2018 requirements, or if your study is under the old Common Rule. Studies approved on, or after, January 21, 2019 are automatically covered by the 2018 requirements. If a document has two versions, those covered by the 2018 requirements MUST use the version of the document with 2018 in the title. If your study was approved prior to January 21, 2019 the study will be covered by the old common rule. If there are two versions of the document, these studies MUST use the version without 2018 in the title. Currently, we are not transitioning any studies that were approved prior to January 21, 2019, to the 2018 requirements.(Click here if you need descriptions of the IRB forms 56KB, MSWord)
Acknowledgement of the Notice of Privacy Practices (309KB, PDF)
Addition of Research Personnel Form (See: Research Personnel Change Form)
Accounting of Disclosures (43KB, MSExcel)
Application for Case Report Review (56KB, MSWord)
FDA Form 1571 (FDA Forms Page)
FDA Form 1572 (FDA Forms Page)
Human Research Event Report (HRER) is now the Reportable Events Form
Human Subjects Audit Tool (427KB, MSWord)
Informed Consent: Glossary of Lay Terms for Use in Preparing Consent Forms (58KB, PDF)
IRQ Appendix L (Scope of Work) (74KB, MSWord)
List of 18 HIPAA Identifiers (28.5KB, MSWord)
Monitoring Visit Report (35KB, MSWord)
NCI CIRB ICF Addendum (20KB, MS Word)
QA/QI (Quality Assurance/Quality Improvement) vs. Research Checklist (58KB, MSWord)
Radiological Procedure Chart (27KB, MSWord)
Reportable Events Form (52KB, MSWord)
Reportable Events Reviewer Checklist for Initial Reviews (101KB, MSWord)
Reportable Events Reviewer Checklist for Meetings (104KB, MSWord)
Repository Frequently Asked Questions (FAQs) (38KB, MSWord)
Revocation of Authorization for Use & Release of Individually Identifiable Health Information for Veterans Health Administration Research (1,897KB, PDF)
Scope of Work Form (See: IRQ Appendix L)
Site Visit Monitoring Report (See: Monitoring Visit Report)
VHA Notice of Privacy Practice (VA Web Site, PDF)
Detailed Descriptions of IRB Forms:
Explanation of IRB Forms (56KB, MSWord)
Determination of IRB Review Forms
Are you unsure if your project requires IRB review and approval?
If yes, please address your question in writing to the IRB Coordinators as a group at email@example.com. Requests should include a detailed explanation of the project and how the project will be conducted. The IRB Coordinators will forward written requests to the IRB when necessary or request that you fill out one of the forms below.
Otherwise, you may complete the appropriate form below and submit it to the Research Service office. The Research Service will make the determination as to whether or not the project requires IRB review and approval. You may not start the project until you have received written confirmation from the Research Service that the project may be initiated.
A detailed description of each of the forms is available by clicking here.
Application for Case Report Review (56KB, MSWord)
Quality Assurance/Quality Improvement vs. Research Checklist (58KB, MSWord)
Research Preparation Application (76KB, MSWord)
Effective June 30, 2021, all packages requiring SRS review must be submitted in VAIRRS.Safety Approval of Research Proposals
Approval from the Subcommittee on Research Safety (SRS) is required for any project that includes work taking place in a VA research lab. This includes work with chemicals, biospecimens (including establishing a biorepository), cells/tissue culture, microbiological agents, recombinant DNA, controlled substances, or radioisotopes.
Laboratory Chemical Inventories and Safety Data Sheets
Each investigator with a VA wet lab is required to maintain an online Safety Data Sheet (SDS) database for hazardous chemicals using the VA SDS/Chemical Inventory Service. This database is reviewed by multiple regulatory entities throughout the year. The VAPORHCS Industrial Hygienist will require an assurance from the PI twice yearly that the inventory is up-to-date. To begin the process to request database access, contact the SRS Coordinator at firstname.lastname@example.org. Additionally, all individuals working in a VA wet lab must be trained by the PI to locate an SDS for a chemical, either by using the VA chemical inventory database or by locating the chemical’s SDS on the manufacturer’s website.
Letter of Intent (LOI)Letter of Intent (VA Web Site, PDF)
This form must be completed when submitting a Career Development or Merit Review Application to the following VA Services:
Career Development (VA Web Site)
Rehabilitation Research & Development (RR&D) (VA Web Site)
VA Research Support Agreement
VA Research Support Agreement (VA Web Site, PDF)
This is a post-award form. This signed agreement is required prior to award of Merit Review Funding from Medical Research Service and Rehabilitation Research & Development Service. Once you have printed and signed this form, it must be submitted to the Research Service Office for additional signatures and routing.
In order to submit a Career Development Application, the investigator must submit a Letter of Intent (LOI). The LOI must be approved by Central Office before the applicant can submit an entire proposal. The Letter of Intent form is below.
10-1313-13 (VA Web Site, PDF)
Listed below are the forms needed to submit a complete Career Development Application.
10-0102 (Cover Page) (VA Web Site, PDF)
10-1313-3 (VA Web Site, PDF)
10-1313-4 (VA Web Site, PDF)
10-1313-5 (VA Web Site, PDF)
10-1313-6 (VA Web Site, PDF)
10-1313-7 (VA Web Site, PDF)
10-1313-8 (VA Web Site, PDF)
Memorandum of Understanding (MOU) with OHSU
Memorandum of Understanding (MOU) for OHSU (OHSU Web Site)
MOUs are an NIH requirement in the cases of joint university/VA appointments. Any PI who is compensated (paid) by both VA and OHSU must initiate an MOU when submitting a grant to NIH to be administered at OHSU, regardless of within which facility he/she will conduct the research. VA Without Compensation (WOC) appointees do not need MOUs because they do not receive VA salary compensation.
To submit grants to Oregon Health & Science University, go to the OHSU grants web site. Grants for which the funds are administered through OHSU, such as NIH grants, must also be submitted through the OHSU Research Office.
For New Investigators
The Investigator Data Sheet (also called a “page 18") is needed for investigators new to the VAPORHCS. It is completed once and updated on an annual basis.
Investigator Data Sheet Form (26KB, PDF)
Hiring New Employees
Work Order Request
Please fill out the work order request (31KB, MSWord) with all the appropriate information and then email the completed form to the Research Administration Office at: Vhapor-ResearchWOC@va.gov
All Research Types:
Code of Conduct in Research (14KB, MSWord)
Conflict of Interest in Research (47KB, PDF)
Credentialing of Personnel Involved in Research (33KB, PDF)
Education Requirements for the Conduct of Research (169KB, PDF)
Physical Security of Research Space; And the Control of Hazardous Agents (218KB, PDF)
Presentation and Publication Policy (83KB, PDF)
Research and Development Committee Standard Operating Procedures (103KB, PDF)
Research Records Management Policy (108KB, PDF).
Research Information Protection Program (RIPP) (200KB, PDF)
Research Misconduct (65KB, PDF)
Responsibilities of the Principal Investigator (All Research Types) (50KB, MSWord)
Responsible Conduct of Research at the VAPORHCS (52KB, PDF)
Research & Development Service Emergency Preparedness Plan (54KB, PDF)
Human Subjects Research:
Institutional Review Board Policies and Procedures (1,123KB, MSWord)
Exemption Subcommittee Policies and Procedures (70KB, MSWord)
VA NCI Central Institutional Review Board Policies and Procedures (95KB, MSWord)
VA WIRB Standard Operating Procedures (54KB, MSWord)
VA Advarra Standard Operating Procedures (46KB, MSWord)
Link to Human Research Protection Program (HRPP) Policies
Link to Veterinary Medical Unit Policies
Link to Institutional Animal Care and Use Committee (IACUC) Guidelines
Wet Lab Research:
Biosafety Manual (1,022KB, MSWord)
Chemical Hygiene Plan (645KB, MSWord)
Link to Subcommittee on Research Safety Standard Operating Procedures (SOP)
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