Forms

VCHRI forms and resources

Operational Approval of Research
Forms & Guidance Notes
File Type File Name Revision Date
Form VCH Operational Research Review Application (formerly "Request for Approval to Conduct Research Form") Oct 31, 2013
Guidance Note Guideline for Obtaining Operational Approval of Research at Vancouver Coastal Health Jun 26, 2014
Form Renewal of Operational Research Approval Oct 22, 2013
Form Notification of Study Completion or Termination Mar 25, 2014
Form VCHA - Richmond Impact Analysis Aug 31, 2011
Ethics Guidance Note When Does Your Project Warrant Review by a Research Ethics Board? Oct 6, 2012
Department Forms
File Type File Name Revision Date
Form Anatomic Pathology Laboratory Resource Utilization Mar 4, 2014
Form Operating Room Research Form Apr 8, 2010
Form Specimen Collection for Research - Special Handling Instructions Apr 5, 2011
Form VCH Medical Device Reprocessing Form Oct 31, 2013
Guidance Note VCH Research Device Guidance Oct 31, 2013
Investigational Devices Presentation Nov 14, 2013
Form Radiology - MI Research Requirement Form Jan 15, 2014
Form Radiology - Screening Checklist Jan 15, 2014
Form Radiology - CT Scan Template Jan 15, 2014
Form Radiology - MRI Study Template Jan 15, 2014
Form Radiology - Nuclear Medicine Study Template Jan 15, 2014
Data Access and Privacy
File Type File Name Revision Date
Policy VCHRI Principal Investigator Terms and Conditions Jul 17, 2014
Form Confidentiality Undertaking for Research Projects Mar 22, 2010
Form Data Access for Research Project Application Nov 4, 2009
Policy VCH Privacy & Confidentiality Policy Sep 11, 2010
Form PCIS Training Registration Form for Research Personnel Jun 3, 2010
Guidance Note Best Practices Regarding Privacy & Researchers Feb 1, 2011
Department Costing
File Type File Name Revision Date
Guidance Note Laboratory Costing List Jun 20, 2012
Guidance Note Pathology Costing List Nov 1, 2011
Guidance Note Pharmacy Costing List Sep 4, 2012
Guidance Note Radiology Costing List May 3, 2013
Clinical Trials Administration
Clinical Trials Administration
File Type File Name Revision Date
Form Clinical Trials Synopsis Form Jun 17, 2010
Form UBC Research Project Information Form May 3, 2013
Guidance Note FAQs - Active Clinical Trials Directory Oct 15, 2013
Form Recruitment Support Form Oct 22, 2013
Form Sponsor Approval Form - Active Clinical Trials Directory Oct 15, 2013
Funding Opportunities
Innovation and Translational Research Awards
File Type File Name Revision Date
Guidance Note Innovation and Translational Research Awards Guidelines 2014 Jan 8, 2014
Form Innovation and Translational Research Awards Research Module 2014 Jan 10, 2014
Form Innovation and Translational Research Awards Statement of Support 2014 Dec 18, 2013
Form VCHRI Grant Cover Sheet Dec 18, 2013
Sidhoo Fund
File Type File Name Revision Date
Guidance Note Sidhoo Trainee Travel Fund Guidelines Dec 18, 2013
Team Grants
File Type File Name Revision Date
Form Team Grants Registration Form 2014 Dec 18, 2013
Form Team Grants Research Module 2014 Dec 18, 2013
Form Team Grants Statement of Support 2014 Dec 18, 2013
Form VCH Research Cover Sheet for VCH Staff Dec 18, 2013
Form VCH Research CV Module Dec 18, 2013
Guidance Note Team Grants Guidance Notes 2014 Dec 18, 2013
Guidance Note Team Grants Guidelines 2014 Dec 18, 2013
Form Team Grants Mentorship Plan 2014 Dec 18, 2013
New Researcher Orientation
General Forms
File Type File Name Revision Date
Form Lab Coat Requisition Form May 3, 2013
Form VCHRI Photo ID, Card Access, & Key Request Form Feb 1, 2014
Building Access Maintenance
File Type File Name Revision Date
Guidance Note Do Not Recycle May 3, 2013
Guidance Note Recycle It Poster May 3, 2013
Guidance Note Recycling FAQ May 3, 2013
Guidance Note Recycling Information May 3, 2013
Health & Safety - Manuals & Procedures
VCH Research Forms
File Type File Name Revision Date
Form First Aid Kit – Treatment Record Sheet May 3, 2013
Form Monthly Checklist Jan 23, 2011
Guidance Note Nov 29, 2010 Privacy and Fax Nov 29, 2010
Form October 31, 2011 Fire Wardens for HP, JBRC, RP, RHNH & WCC May 3, 2013
Form Personal Safety Checklist May 6, 2013
Form Safety Course Registry May 6, 2013
Guidance Note Sept 11, 2012 VCH Information Privacy & Confidentiality Sep 11, 2012
Form Training Record May 3, 2013
Workplace Accident/Incident Forms
File Type File Name Revision Date
Form 2005 Edition WorkSafe BC WHMIS Manual Sep 30, 2011
Form April 27, 2012 VCHRI Orientation Guide Apr 27, 2012
Guidance Note Contact list for Chemical Waste Disposal May 3, 2013
Form Faculty & Staff Incident / Accident Report (with instructions) Nov 1, 2011
Form Hazard, Incident, Accident Flow Chart Apr 10, 2011
Guidance Note January 2006 Emergency Response Codes May 3, 2013
June 14, 2011 Lab Waste Procedures Jun 14, 2011
Guidance Note June 23, 2011 Earthquake Response Procedure Jun 23, 2011
Guidance Note June 23, 2011 Liquid Nitrogen Hazards Jun 23, 2011
Form Sept 29, 2011 VCHRI Safety Program Manual Sep 29, 2011
Guidance Note Spill Reporting Flow Chart May 3, 2013
Form Student & Visitor Incident / Accident Report Apr 1, 2005
Worksafe BC Forms for UBC Employees
File Type File Name Revision Date
Form WorkSafe BC: Form 6: Application for Compensation & Report of Injury or Occupational Disease May 6, 2013
Form WorkSafe BC: Form 6A: Worker’s Report of Injury or Occupational Disease to Employer May 6, 2013
Form WorkSafe BC: Form 7A: First Aid Report May 6, 2013
Financial Administration - UBC
Accounts Payable
File Type File Name Revision Date
Form AMEX direct deposit form Oct 1, 2010
Form Change Request to Active PO Nov 24, 2011
Form Department Cash/Coin Order Form May 3, 2013
Form Electronic Funds Transfer(EFT) Form Aug 1, 2011
Form FIA 3rd Party Travel paid by UBC May 3, 2013
Form HST Small Supplier Status Declaration Form May 3, 2013
Form Journal Voucher May 3, 2013
Form Journal Voucher for Air Canada Corporate Pass May 3, 2013
Form Missing Receipt Form Jul 16, 2010
Form PO/QREQ Threshold Exemption Justification May 3, 2013
Form Q-Requisition for Payment Form May 3, 2013
Form Relocation Reimbursement Claim Form Feb 9, 2011
Form Travel Requisition for Payment Form May 3, 2013
Budget Office
File Type File Name Revision Date
Form GPO Fund Transfer Form May 3, 2013
Form GPO Planned Funding Adjustment Form May 3, 2013
Form Hyperion Access Request Form May 3, 2013
Form PLNTUIT Request Form May 3, 2013
FInancial Reporting
File Type File Name Revision Date
Form Chartfield Request form May 3, 2013
Form Endowment Transfer Request Form May 3, 2013
Form Operating Plan excel form May 3, 2013
Form PG Inactivation Form - General May 3, 2013
Form PG Request form May 3, 2013
FMS
File Type File Name Revision Date
Form FMS nQuery Security Administrator application May 6, 2013
FMS nQuery Access Request Form
File Type File Name Revision Date
Form FMS May 6, 2013
Management Reporting
File Type File Name Revision Date
Form Hyperion Report Request Form May 3, 2013
Office of Research Services - UBC
File Type File Name Revision Date
Form Signature Form Template May 6, 2013
Payroll - Beneficiary designation
File Type File Name Revision Date
Form Basic Life Beneficiary designation Feb 2, 2009
Form Optional Life Beneficiary designation Feb 2, 2009
Form Spousal Life Beneficiary designation Feb 2, 2009
Payroll - Dental Plans
File Type File Name Revision Date
Form Cancel Dental Coverage May 6, 2013
Form Combined Dental + HSA, Management & Professional only May 6, 2013
Guidance Note Dental Claim Form, Faculty and Staff with the exception of Mangement & Professional May 6, 2013
Form Enrol for Dental Benefits May 6, 2013
Payroll - Extended Health
File Type File Name Revision Date
Form Cancel Extended Health May 6, 2013
Form Change your address or update your dependents May 6, 2013
Form Enrol for extended health benefits May 6, 2013
Form Extended Health + HSA, Management & Professional only May 6, 2013
Form Extended Health Claim Form, Retirement and Survivor Benefits members only May 6, 2013
Form Extended Health Claim Form, with the exception of Management & Professional May 6, 2013
Payroll - Health Benefits
File Type File Name Revision Date
Form Newborn/Adoption Enrolment Form Jul 1, 2010
Form Opt out of the AMS health plans May 3, 2013
Payroll - Income Replacement (Disability Insurance)
File Type File Name Revision Date
Form Faculty Enrolment form Dec 1, 2007
Form Other Application form (DBP) Jun 1, 2010
Form Staff Application form (IRP) Dec 3, 2007
Payroll - Management and Faculty Optional Life Application Forms
File Type File Name Revision Date
Form M&P and Faculty OPT Reduction/Cancellation Jul 30, 2010
Form M&P and Faculty Optional Life Application Jan 30, 2009
Payroll - Medical Services Plan (MSP)
File Type File Name Revision Date
Form Cancel MSP May 3, 2013
Form MSP Application Form May 3, 2013
Form MSP Change Form May 3, 2013
Payroll - Miscellaneous
File Type File Name Revision Date
Form Payroll direct deposit May 3, 2013
Form Payroll direct deposit May 3, 2013
Form Payroll direct deposit cancellation/change May 3, 2013
Form Personal data changes (incl. address changes) May 3, 2013
Form Personal data changes (incl. address changes) May 3, 2013
Form Request for Hourly Vacation Pay, Record of Employment May 3, 2013
Form Request for information May 3, 2013
Form TD1 Tax form (BC) May 3, 2013
Form TD1 Tax form (federal) May 3, 2013
Payroll - Staff Optional Life Application Forms
File Type File Name Revision Date
Form Staff OPT Reduction/Cancellation Dec 30, 2005
Form Staff Optional Life Application Jan 30, 2009
Payroll - UBC Administrative
File Type File Name Revision Date
Form Faculty Appointment Form Apr 18, 2012
Form Faculty Honoraria Lump Sum Form Jun 5, 2012
Form Leave of Absence Nov 8, 2012
Form Staff Appointment Form Nov 8, 2012
Form Staff Honoraria Lump Sum Form May 6, 2013
Form Student Appointment Form May 6, 2013
Form Timesheet May 6, 2013
Transfer and Severance Notice Nov 8, 2012
Research & Trust Accounting
File Type File Name Revision Date
Form Collaborative Financial Statement Form May 6, 2013
Form General Financial Statement Form May 6, 2013
Form PG Inactivation Form - Research and Specific Purpose May 6, 2013
Form Start-up Grant Request Form May 6, 2013
Form Tricouncil Form 300 May 6, 2013
Revenue Accounting
File Type File Name Revision Date
Form Merchant Account Request Form May 6, 2013
Form Merchant Service/Equipment Cancellation Form May 6, 2013
Other
File Type File Name Revision Date
Form Equipment Register May 6, 2013
Form Request to Move Equipment May 6, 2013
Office of Research Services - UBC
Cover Sheet & Summary Forms
File Type File Name Revision Date
Form Faculty of Medicine Grant Application Cover Sheet Jun 1, 2010
Form Signature Form Template May 6, 2013