Form Number | Title | Revision Date | Adobe PDF |
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| Health and Human Services (HHS) | | |
HHS-419 | Clearance of Employees for Separation or Transfer | 12/10 | |
HHS-520 | Request for Approval of Outside Activity | 01/06 | |
HHS-521_508 | Annual Report of Outside Activity | 01/06 | |
HHS-568 | Procedures for Submission of Final Invention Statement | 06/09 | |
HHS-687 | Consent to Sterilization | 05/10 | |
HHS-687-1 | Consent to Sterilization (Spanish Version) | 11/03 | |
HHS-690 | Assurance of Compliance | 01/09 | |
HHS-697 | Foreign Activities Questionnaire | 04/02 | |
HHS-719 | Request for Copy of the Record(s) in the Case File | 09/05 | |
HHS-720 | Request for Copy of Record(s): Third-Party with the Individual Appellant's Consent | 08/05 | |
HHS-721 | Individual Appellant's Consent to Third-Party for Copies of the Individual Appellant's Record(s) | 08/05 | |
HHS-722 | Request for Substitution of Party Upon Death of Party | 08/05 | |
HHS-723 | Waiver of Right to an Administrative Law Judge (ALJ) Hearing | 08/05 | |
HHS-724 | Request to Correct, Amend, or Delete a Record(s) | 08/05 | |
HHS-725 | Request for Administrative Law Judge (ALJ) to Review Dismissal by the Qualified Independent Contractor | 08/05 | |
HHS-727 | Extension Request to File a Request for an Administrative Law Judge (ALJ) Hearing | 08/05 | |
HHS-728 | Filing of New Evidence | 08/05 | |
HHS-729 | Response to Notice of Hearing | 08/05 | |
HHS-730 | Withdrawal of Request for an Administrative Law Judge (ALJ) Hearing | 08/05 | |
HHS-731 | Withdrawal of Waiver of Right to an Administrative Law Judge (ALJ) Hearing | 08/05 | |
HHS-733 | Identity Verification | 08/05 | |
HHS-734 | Payment Information Report | 09/05 | |
HHS-T-001 | Response to Notice of Hearing | 08/05 | |
| Public Health Service (PHS) | | |
PHS-398 | Application for PHS Grant | 06/09 | |
PHS-416-1 | Application for PHS Individual National Research Service Award Instructions | 06/09 | |
PHS-416-5 | Research Fellowship Activation Notice | 06/09 | |
PHS-416-7 | Termination Notice NRSA | 06/09 | |
PHS-416-9 | Application for PHS Individual National Research Service Continuation Award Instructions | 06/09 | |
PHS-2590 | Application for Continuation of a PHS Grant | 06/09 | |
PHS-3734 | Official Statement Relinquishing Interest and Rights in a PHS Research Grant | 06/09 | |
PHS-6031 | National Research Service Award | 06/09 | |
PHS-6031-1 | Annual National Research Service Award | 06/09 | |
PHS-6349 | Annual Report on Possible Research Misconduct | 12/10 | |
| Program Support Center (PSC) | | |
| 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-171 | Prevention Registry | Exp 06/06 | |
SMA-172 | SAMHSA Application for Peer Grant Review | Exp 06/04 | |
| Indian Health Service | | |
IHS-810 | Authorization for Use or Disclosure of Protected Health Information | 04/09 | |
IHS-912-1 | Request for Restriction(s) | 04/09 | |
IHS-912-2 | Request for Revocation of Restriction(s) | 04/09 | |
IHS-913 | Request for an Accounting of Disclosures | 04/09 | |
IHS-917 | Request for Correction/Amendment of Protected Health Information | 04/09 | |
IHS-963 | Request for Confidential Communication by Alternative Means or Alternate Location | 04/09 | |