Is this a final report (all data have been collected and analyzed)? YES (Complete pages 3 & 4 only) NO (Complete all applicable – pages) -- List principal investigator, co-investigators, and research associates. Fill-in blanks to the right of names. TYPE OF VA VA APPOINTMENT Research funded Financial conflict ROLE & SERVICE Conducted Study Involved in of interest exists R&D Eligibility (i.e. PI, Co-Inv, (i.e. VA, WOC, off-site (yes or lab work for this project (FOR OFFICE USE NAME and DEGREE Research Associate) Contract, IPAA) Phone Email (yes r no) no) (yes or no) (yes or no) ONLY)
Is this a final report – (all data have been collected and analyzed)? YES (Complete pages 3 & 4 only) NO (Complete all applicable pages) -- List principal investigator, co-investigators, and research associates. Fill-in blanks to the right of names. NAME and DEGREE ROLE (i.e. PI, Co-Inv, Research Associate) TYPE OF VA APPOINTMENT & SERVICE (i.e. VA, WOC, Contract, IPAA) Phone Email Research Conducted off-site (yes r no) VA funded Study (yes or no) Involved in lab work (yes or no) Financial conflict of interest exists for this project (yes or no) R&D Eligibility (FOR OFFICE USE ONLY)