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 or Adobe Reader.

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PRE AWARD

• eRA Commons Account Registration Obtain eRA Commons account & affiliate with UTHealth
• Multiple PI Leadership Plan
• Individual Research Conflict of Interest Form
• Unobligated Balance Calculation

POST AWARD

• Cost Transfer Request Used 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 Used to request the closure of grants and contracts when funds vest with UT. (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.
• Gift Card Reimbursement Form Include with the non-po voucher documentation when requesting reimbursement of gift cards purchased.
• Modular Grant Information Use when preparing modular grant budgets.
• Person Months Conversion Chart Use to convert % to person months
• Program Income Setup Request Form
• Relinquishing of Grants Procedures for departments and PAF to follow when a PI relinquishes a project.
• Salary Cap Worksheet (For both NIH & CPRIT) Accompanies PA's with federal grants that are subject to the federal Salary Cap.
• Split Account Request Template Used 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
  • The funding for the second account includes: > 20% salary/effort of the investigator, additional personnel expenses, or non-personnel expenses in addition to the salary.
• Stipend Payments Guidance for departments to use when submitting stipends on a project.
• Subcontractor Tracking Form Used to monitor subcontractor invoices receipt and payment. Departments can optionally use the form.

CLINICAL RESEARCH FINANCE

• Checklist to Expedite Device Study Review A form requested by Memorial Hermann Healthcare System to expedite the review of Device Studies to be conducted at MHHS. This form should be completed and submitted to MHHS as soon as possible.
• CALB Tool Guidance Document This document provides guidance on how to complete the Coverage Analysis/Internal Budget tool. (CAIB tool)
• 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.
• Contract/ Coverage Analysis/ Proposal Record Workflow Document  This workflow document provides an overview of the start -up process in SPA  for industry initiated clinical studies.
• Coverage Analysis Fees -Industry Sponsored Studies This sheet  provides a breakdown of fees with and without IDC applied.
• Coverage Analysis Fee Memo for Industry Sponsors This memo provides information to provide to Industry Sponsors regarding coverage analysis fees.

• EPIC Tip Sheet- Study Coordinator Guide This tip sheet discusses how to link patients to studies, how to link visit encounters to studies, and how to review charges for research visits in Epic
• EPIC Tip Sheet- Manage Study Record This tip sheet discusses how to manage the study record in Epic
• Harris Health Patient Registration Form
• MHH Patient Registration Form

BUDGET TEMPLATES

• Clinical Trial Budget Template with Coverage Analysis Grid Development 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 and Directions Assist in the development of internal budgets for proposals. Use this template for large proposals with numerous personnel and expense lines, such as program projects. 
• Other Support Example Template - 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 Required for all non-cash basis award set-ups, including cost reimbursable, fee-for-service, and milestone payment accounts with subcontracts.
• Set-up Budget Worksheet and Directions Required for all non-cash basis award set-ups, including cost reimbursable, fee-for-service, and milestone payment accounts.
• Simple Detailed Budget and Directions Assist in the development of internal budgets for proposals. Use this template for standard proposals.

EFFORT

• ECC Access Request Form Gain access to ECC, effort reporting system
• Funding History Access Request Form (email systemsreporting@uth.tmc.edu for access)
• Effort Minimum / Maximum Waiver Request a waiver to minimum & maximum effort requirements/policy
• Person Months Conversion Chart Use to convert % to person months

SYSTEM ACCESS FORMS

• ECC Access Request Form - Gain access to ECC effort reporting system
• eRA Commons 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