The VA Research and Development Committee, in addition to the HAC, must approve all protocols involving VA patients or facilities. If use of VA patients or its facilities is contemplated, contact the VAMC Research Service at 706-823-2238 to obtain VA forms. All changes in the protocol including performance site must be submitted to the VA Research and Development Committee in addition to the HAC.

INSTRUCTIONS FOR SUBMISSION OF VA PROTOCOLS FOR SUBMISSION TO RESEARCH & DEVELOPMENT COMMITTEE

Send to Research (VAMC 242) the following: 

Original only of the following:

• Page 18 (VAF 10-5368) (If new investigator)

• Personal Data on VA Investigator (If new investigator)

• Request to Review Research Proposal

• Attach Abstract (Objective, Research Plan, Method)

• Completed Outside Service Impact Statement

• Hazardous Chemical Questionnaire

• Investigational Drug Information Record

• (VAF 10-9012) (If applicable) 

• VA Form 10-3203, Consent for Use of Picture and/or Voice (if applicable)

• VA Form10-5345, Subjects With A History Of Alcoholism, Drug Abuse, Sickle Cell
  Anemias, Infection With HIV (if applicable)

 

One copy of the following:

• Signed Statement of Investigator, Form FDA 1572

• Pharmacy Fee Sheet

• Signed contract between funding source and administrator

• The budget page

One copy of HAC approval letter (if HAC approved) and approved VA Informed Consent (VA 10-1086).

If not yet HAC approved, send a copy of the approval letter immediately upon receipt.

Four collated sets:

• HAC submission  (All forms submitted to the HAC)

• Scientific Protocol

Please call Linda Ball at the VAMC, 706-823-2238 or ext. 2509, for forms, with questions, for help, interpretation, or additional information.

 

*VA consent form only

NOTE:  Per VHA Directive 2000-043: "Banking of Human Research Subjects' Specimens", only those tissue banks that are designated as VA-approved tissue banks can collect, use or store human biological specimens.  For a list of those designated banks, contact the ACOS/Coordinator at 706-823-2238.