VA Form 10-0455a Clinical Trial Inclusion / Enrollment Report

VA Form 10-0455a Clinical Trial Inclusion / Enrollment Report

What Is VA Form 10-0455a?

This is a legal form that was released by the U.S. Department of Veterans Affairs on November 1, 2008 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is VA Form 10-0455a?
A: VA Form 10-0455a is a Clinical Trial Inclusion/Enrollment Report.

Q: What is the purpose of VA Form 10-0455a?
A: The purpose of VA Form 10-0455a is to report the inclusion and enrollment of patients in clinical trials.

Q: Who needs to fill out VA Form 10-0455a?
A: This form needs to be filled out by individuals or organizations conducting clinical trials at VA facilities.

Q: Is VA Form 10-0455a mandatory?
A: Yes, VA Form 10-0455a is mandatory for reporting the inclusion and enrollment of patients in clinical trials conducted at VA facilities.

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Form Details:

  • Released on November 1, 2008;
  • The latest available edition released by the U.S. Department of Veterans Affairs;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of VA Form 10-0455a by clicking the link below or browse more documents and templates provided by the U.S. Department of Veterans Affairs.

Download VA Form 10-0455a Clinical Trial Inclusion / Enrollment Report

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  • VA Form 10-0455a Clinical Trial Inclusion / Enrollment Report, Page 1
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