security? If yes submit “ISO/PO Checklist for CRs and Mods”. Has there been any change in location of electronic or hard copy data? If yes submit updated Research “VAMHCS Data Inventory Tool” Yes No Has there been any change in location of tissue repository or data repository? Yes No The table below must be completed for all team members If the team member interacts with VAMHCS patients, performs procedures at the VAMHCS, or has access to VA data then all information for the person must be listed here. Confirmation of required items for study team members: VA Status, Required Trainings and Scope of Practice VA VA Privacy CITI Scope of and Privacy Training Practice Information and HIPAA Security Policy (copy Awareness Principal Training (required should be and Rules of Investigator, Status of Team 3 on file in every behavior Member Research years) (required Office and (required annually) also in study ALL and annually) binder) Research Team Members VA WOC ** Paid (List UM/ Date Date Date Date ACOS expiration Staff Non date on VA Completed Completed Completed signed most recent (only) WOC appointment letter) **If this study is a collaborative project and there are team members who do not participate on the VA portion of the study they should be listed here as UM/Non VA only and no other info on status, trainings or Scope of Practice is required.
security? If yes submit “ISO/PO Checklist for CRs and Mods”. Has there been any change in location of electronic or hard copy data? If yes submit updated “VAMHCS Research Data Inventory Tool” Yes No Has there been any change in location of tissue repository or data repository? Yes No The table below must be completed for all team members If the team member interacts with VAMHCS patients, performs procedures at the VAMHCS, or has access to VA data then all information for the person must be listed here. Confirmation of required items for study team members: VA Status, Required Trainings and Scope of Practice Principal Investigator, and ALL Research Team Members Status of Team Member VA Privacy and HIPAA Policy Training (required annually) VA Privacy and Information Security Awareness and Rules of behavior (required annually) CITI Training (required every 3 years) Scope of Practice (copy should be on file in Research Office and also in study binder) VA Paid Staff WOC (List expiration date on most recent WOC appointment letter) ** UM/ Non VA (only) Date Completed Date Completed Date Completed Date ACOS signed **If this study is a collaborative project and there are team members who do not participate on the VA portion of the study they should be listed here as UM/Non VA only and no other info on status, trainings or Scope of Practice is required.
RDCsubmitWS_AnnualUpdateChange.docx