United States Department of Veterans Affairs
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Instructions to Request 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 go to the Intranet version of this page at http://vaww.research.va.gov/requip/request-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 Offices/R&D Coordinators wishing to request equipment must submit a completed online editable version of VA Form 10-1274a (Inquiry on Availability of an Instrument from VA REQUIP) electronically to the REQUIP Coordinating Officer at Requip@va.gov.

  • An e-mail directly from the ACOS' computer containing an electronic signature or typed name and title is acceptable signature on VA Form 10-1274a.
  • 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 10-1274a directly to the REQUIP mailbox by clicking the "E-mail Button" at the bottom of the form.
  • A separate VA Form 10-1274a must be submitted for each instrument.