U.S. Department of Health & Human Services
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Form
Number
Title
Revision
Date
Form
Link
 

Health and Human Services (HHS)

   
HHS-568 Procedures for Submission of Final Invention Statement
08/12
Adobe PDF Icon
HHS-690 Assurance of Compliance
01/09
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HHS-691 Request for Special Pay for Physicians and Dentists
10/06
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Public Health Service (PHS)

   
PHS-398 Public Health Service – Includes Research Career Awards and Institutional National Research Service Awards
08/12
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PHS-416-1 Application for an Individual National Research Service Award Fellowship
Instructions
08/12
PHS-416-5 Research Fellowship Activation Notice
08/12
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PHS-416-7 Termination Notice NRSA
08/12
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PHS-416-9 Application for PHS Individual National Research Service Continuation Award
Instructions
08/12
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PHS-1813 Reference Request for Applicants to the U.S. Public Health Service Commissioned Corps
12/13
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PHS-2271 Statement of Appointment of Trainee
08/12
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PHS-2590 Application for Continuation of a PHS Grant
08/12
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PHS-3734 Official Statement Relinquishing Interest and Rights in a PHS Research Grant
08/12
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PHS-6031 National Research Service Award
08/12
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PHS-6031-1 Annual National Research Service Award
08/12
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PHS-6315 Assurance of Compliance by Sub-Award Recipients
05/14
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PHS-6349 Annual Report on Possible Research Misconduct
10/15
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Substance Abuse and Mental Health Services Administration (SAMHSA)

   
SMA-162 Application for Certification to Use Opioid Drugs in a Treatment Center
01/03
SMA-167 Notification of Intent to Use Opioid Drugs for Maintenance and Treatment
00/00
SMA-172 SAMHSA Application for Peer Grant Review  Exp 06/04
 

 

Indian Health Service

   
IHS-810 IHS Authorization for Release of Information 04/09 Adobe PDF Icon
IHS-843-1A Order for Health Services 07/14 Adobe PDF Icon
IHS-913 Request for an Accounting of Disclosures 04/09 Adobe PDF Icon
IHS-963 Request for Confidential Communication by Alternative Means or Alternate Location 04/09 Adobe PDF Icon
IHS-917 Request for Correction/Amendment of Protected Health Information 04/09 Adobe PDF Icon
IHS-912-1 Request for Restriction(s) 04/09 Adobe PDF Icon
IHS-912-2 Request for Revocation of Restriction(s) 04/09 Adobe PDF Icon

 

Content created by Program Support Center (PSC)
Content last reviewed on October 31, 2014