United States Department of Veterans Affairs
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Instructions for Listing Available Equipment

Links to Forms

Note: Word documents not "form-fill"; must be printed, completed, and sent as PDF file attachments to REQUIP@va.gov.

These PDF forms are available on the VA Intranet only.

  • VA Form 134 - Combination Requisition and Shipping Ticket
  • VA Form 222 - Request for and Notice of Shipment
  • VA Form 10-1274 - Research Equipment Available To VA REQUIP Program
  • VA Form 10-1274A - Inquiry On Availability Of An Instrument From VA REQUIP Program
If you have Intranet access, please see the Intranet version of this page at http://vaww.research.va.gov/requip/list-equipment.cfm to download the forms.

If you have Adobe version 5.0.0, you must upgrade to Acrobat Reader version 8 to view and print the forms. You can download the free software at Adobe Acrobat Reader.

  • Research equipment for reassignment must be reported electronically to the REQUIP Coordinating Officer at Requip@va.gov by the local Research Office ACOS/R&D or designee on a completed online editable version of VA Form 10-1274 (Research Equipment Available to VA REQUIP Program).
  • An e-mail directly from the ACOS' computer containing an electronic signature or typed name and title is acceptable signature on all required forms for the REQUIP Program.
  • Forms are considered complete when ALL numbered blocks or spaces on the forms are answered appropriately. Insert N/A if item is unknown or not applicable.
  • Submit completed VA Form 10-1274 directly to the REQUIP mailbox by clicking the "E-mail Button" at the bottom of the form.
  • A separate VA Form 10-1274 must be submitted for each instrument.
  • The local Research Office must e-mail a completed local safety officer/industrial hygienist checklist and biomedical engineer checklist, as PDF files, in addition to the VA Form 10-1274 to Requip@va.gov.
  • The completed checklists must have original signatures and should be submitted to Requip@va.gov as pdf files.
  • Separate checklists must be submitted for each instrument.
  • An individual *digital color photo of available equipment may be submitted (encouraged but not required) along with VA Form 10-1274.

*Digital Color Photo of Equipment

  • E-mail a JPG, TIF, or BMP file to Requip@va.gov along with the completed VA Form 10-1274 (Research Equipment Available to VA REQUIP Program).
  • The website support staff will size the photo appropriately.

Criteria for Screening Equipment for Redistribution

  • Acquisition cost of equipment is $5,000 or greater;
  • Equipment is confirmed to be functional (unless prior arrangements are made through the REQUIP Coordinator) by the local biomedical engineer;
  • Local industrial hygienist certifies that equipment has no detectable contamination; and
  • All required completed forms are received by the REQUIP Coordinating Officer at Requip@va.gov:
    a. VA Form 10-1274 (Research Equipment Available to VA REQUIP Program);
    b. Biomedical engineer checklist;
    c. Local safety officer/industrial hygienist checklist; and
    d. Digital photo (any size) of instrument (encouraged but not required).

Equipment Listing

The originating facility will be notified via e-mail of the date the screening criteria are satisfied. The REQUIP Coordinating Officer will then contact the originating facility within 3 business days to request that the Research Office either

  1. hold the equipment for posting on the ORD website at http://www.research.va.gov/programs/requip (post for maximum of 45 calendar days) or
  2. excess the equipment through the local Property Manager using VA Form 10-1274 (Research Equipment Available to VA REQUIP Program).