Looking for a Va Form 10-1436 -? Download it for free!

INSTRUCTIONS FOR COMPLETING VA FORM 10-1436 - PROJECT DATA SHEET

GENERAL:

A Project Data Sheet (VA Form 10-1436) is required (M-3, Part I, Change 4) for research involving VA

facilities, resources, employees, or patients. An initial Project Data Sheet must be submitted within 15 days

after the initiation of the project. A Progress report must be submitted annually thereafter.

If the principal investigator (or co-principal investigator) has not completed an Investigator Data Sheet (Page

18 -VA Form 10-5368) at this medical center, a completed Investigator Data Sheet must be returned with this

Project Data Sheet.

Projects funded by Cooperative Studies are reported only by the Study Chairperson. HSR&D Field Programs

are reported only by the HSR&D Field Program Director. For projects with co-principal investigator(s), submit

only one Project Data Sheet, arbitrarily designating one co-principal investigator as principal investigator

responsible for completing the Project Data Sheet. Report the remaining co-principal investigator(s) in item 10.

SPECIFIC ITEMS:

Principal/Co-Principal Investigator--All Principal Investigators (and Co-Principal Investigators)

Item 3:

must have a VA appointment. If the Principal Investigator of the project does not have a VA

appointment, but if a portion of the project is to be done at the VA by a VA investigator, enter

the VA investigator as the Principal Investigator and code item 5 (below) as "02".Only one

name is to be entered in this space.

Item 5:

Status of PI in Project--Mark "02" only if you are not the recipient of the grant or award or not

the initiator of the project.

Item 6:

Project Number--Each project must have a 4 digit project number.

Item 8:

Project Title--Do not exceed 142 spaces.

Item 9:

Project Title Change--If the project title has changed since last report, mark "YES." A title

change is permissible ONLY if there is NOT a change in funding source(s) (see item 12).

Item 10:

In the case of Co-Principal Investigators, list one as Principal Investigator in item 1. Do not

enter the names of Co-Investigators or anyone who does not have a VA appointment.

Item 11:

Funding and Administration--Funding and Administrative codes are on the back of this page. It

is possible to designate up to three funding sources and administrative codes for a single

project. Do NOT, however, use a generic title for your research projects and designate multiple

funding sources for your overall effort. Keep projects separate.

Item 14:

Key words are checked against the Medical Subject Heading (MeSH) index which is maintained

by the National Library of Medicine. A list of these terms is located in the Research Office or

the VA library.

Item 15:

Project Abstract--Organize abstract under the following headings: (a) objective of the project;

(b) research plan; (c) methodology, and (d) findings, results or conclusions reached to date.

Limit to 500 words.

Page 3

VA FORM

10-1436

JUN 1989

Va Form 10-1436 - Page 3

Related Articles

Related forms

Related Categories