FORMS & TEMPLATES

SPA offers a variety of its forms, templates, and worksheets, in PDF and Excel format. In order to read, print, search, and fill-in PDF forms, you will need a copy of Adobe Acrobat orAdobe Reader.

Forms must be downloaded in order to save them. To do so, right-click the link, click "Save Target As...", then choose the destination on your computer.

New!How to open pdf forms in Chrome

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PRE AWARD

• 时代下议院Account RegistrationObtain eRA Commons account & affiliate with UTHealth
• Multiple PI Leadership Plan
• Individual Research Conflict of Interest Form
• Unobligated Balance Calculation

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POST AWARD

• Cost Transfer RequestUsed by departments to transfer expenses onto or off of a sponsored project. (Guidance is provided on the form for backup support.)
• Contract Residual Closeout Form当资金与UT归属时，用于要求关闭赠款和合同。(Rename and save the PDF form to your hard drive, complete and forward within your department for approval. Return to PAF when completed.)Clinical Closeout requests should not use this form.
• Effort Report Calculation CheckEnsures each months effort is applied correctly and totals appropriately for each six month reporting period.
• Gift Card Reimbursement FormInclude with the non-po voucher documentation when requesting reimbursement of gift cards purchased.
• Modular Grant Information准备模块化赠款预算时使用。
• Person Months Conversion Chart使用转换% to person months
• Program Income Setup Request Form
• 放弃赠款当PI放弃项目时，部门和PAF的程序遵循。
• Salary Cap Worksheet (For both NIH & CPRIT)Accompanies PA's with federal grants that are subject to the federal Salary Cap.
• Split Account Request TemplateUsed to add an additional sub-project to a main project.
• SPA does not approve split accounts for just salary of another investigator. Split accounts are done when:
  • There are at least two schools, or
  • It is multi-PI between two departments, or
  • 第二个帐户的资金包括：调查员的薪水/工作量> 20％，除工资外，其他人员费用或非人事费用。
• Stipend PaymentsGuidance for departments to use when submitting stipends on a project.
• Subcontractor Tracking FormUsed to monitor subcontractor invoices receipt and payment. Departments can optionally use the form.

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CLINICAL RESEARCH FINANCE

• Clinical Research Billing ProcedureOutlines the research billing procedure for clinical studies and establishes the responsible parties for appropriate research billing.
• 致电中心“学习访问请求”
• Case Billing Request Form
• Checklist to Expedite Device Study Review纪念Hermann Healthcare系统要求的一种表格，以加快对MHHS进行的设备研究的审查。该表格应填写并尽快提交给MHHS。
• Clinical Research Billing Certification Form
• Clinical Research Charge Document Log
• Clinical Trial Budget Template with Coverage Analysis Grid(CAIB tool) Development of a clinical trial coverage analysis grid and budget. It contains internal price lists and formulas for effort calculations.FOR INTERNAL USE ONLY.
• General "Study Visit Request"
• Guidance on R&A data entry for CTAs
• Harris Health Patient Registration Form
• MHH患者注册表格
• Patient Follow-Up Sheet使用这种形式作为纸质文件to give the patient at checkout for scheduling a follow-up research appointment.
• Contract/ Coverage Analysis/ Budget Workflow DocumentThis workflow document provides an overview of the start -up process in SPA for industry initiated clinical studies.
• Clinical Research Patient Registration /Flagging本文档提供了有关如何确保患者被标记为计费系统和病历中的研究参与者的说明。beplay苹果手机能用吗

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预算模板

• Clinical Trial Budget Template with Coverage Analysis GridDevelopment of a clinical trial coverage analysis grid and budget. It contains internal price lists and formulas for effort calculations.FOR INTERNAL USE ONLY.
• Complex Detailed Budget和DirectionsAssist in the development of internal budgets for proposals. Use this template for large proposals with numerous personnel and expense lines, such as program projects.
• 其他支持示例模板- Must be utilized when responding to any JIT request and when submitting revised other support with annual NIH progress reports.
• Set-Up Budget Worksheet for Subcontracts所有非现金基础奖励设置所需的要求，包括可偿还的成本，服务费和带有分包合同的里程碑支付帐户。
• Set-up Budget Worksheet和DirectionsRequired for all non-cash basis award set-ups, including cost reimbursable, fee-for-service, and milestone payment accounts.
• 简单的详细预算和DirectionsAssist in the development of internal budgets for proposals. Use this template for standard proposals.

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EFFORT

• eCRT Access Request FormGain access to eCRT, effort reporting system
• Effort Calculation WorksheetCalculate payroll percentages; must be used in conjunction with the HCM Funding History file
• Funding History Access Request Form(emailSystemsReporting@uth.tmc.edufor access)
• Effort Minimum / Maximum WaiverRequest a waiver to minimum & maximum effort requirements/policy
• Effort Report Calculation CheckExcel worksheet to allow departments to ensure that each months effort is applied correctly and totals appropriately for each six month reporting period.
• Manual Certification CoversheetUsed to manually certify faculty & their support staff, no longer at the university
• Person Months Conversion Chart使用转换% to person months

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SYSTEM ACCESS FORMS

• ecrt® Access Request Form- Gain access to eCRT effort reporting system
• 时代下议院Account Registration- Obtain eRA Commons account & affiliate with UTHealth
• NSF FastLane Account Registration- Instructions to obtain NSF Fastlane account
• REDCap Access Form- Gain access to RedCap
• Sponsor/Subcontractor Request Form- Request a new UTHealth START sponsor or subcontractor
• Subcontractor Personnel Request Form- Request access for Subcontractor Personnel
• UTHealth START Delegation Form- Users can delegate tasks/To Do Items to other UTHealth employees
• UTHealth START Access Request Form- Gain access to UTHealth START system

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