Forms and Letters

Questions regarding any of these forms should be directed to the individual(s) in parentheses following the form name. If the designated individual(s) cannot be reached, please contact Dana Carroll, Director of ORSP, at 860-679-2202. Contact information is provided below.

Contact Name	Phone	Email
Alison Pohl	860-679-4129	pohl@uchc.edu
Debbie Gaudreau	860-679-2434	gaudreau@adp.uchc.edu
Gloria Veronesi	860-679-4040	veronesi@adp.uchc.edu
Leonard Paplauskas	860-679-3173	paplauskas@adp.uchc.edu
Pam Vachon	860-679-8708	vachon@nso2.uchc.edu
Paul Hudobenko	860-679-3951	hudobenko@adp.uchc.edu

Internal Forms, Letters, and Standard Templates

ORSP Routing Form (Word) – D. Gaudreau/P. Hudobenko

IPAS Instructions (Word) – D. Gaudreau/P. Hudobenko

IPAS Forms/IPAS Final Form (Excel) – D. Gaudreau/P. Hudobenko

Letter of Intent for Research Collaboration Sample – UConn Health Center Prime (Word) – D. Gaudreau/P. Hudobenko

Letter of Intent for Research Collaboration Sample – UConn Health Center Sub (Word) – D. Gaudreau/P. Hudobenko

Material Transfer Agreement (MTA) Cover Sheet (Excel)

Storrs Project Agreement Form (Word) – D. Gaudreau/P. Hudobenko

Storrs Project Agreement Procedures (Word) – D. Gaudreau/P. Hudobenko

ORSP Supplemental Routing Form – Involving Stem Cells (Word) – D. Gaudreau/P. Hudobenko

Stem Cell Support Letter – Hogan (PDF) – D. Gaudreau/P. Hudobenko

Stem Cell Support Letter – Ren-He Xu (PDF) – D. Gaudreau/P. Hudobenko

Stem Cell Support Letter – Flow Cytometry (PDF) – D. Gaudreau/P. Hudobenko

Stem Cell Support Letter – Translational Genomics Core (PDF) – D. Gaudreau/P. Hudobenko

Requirements for Including Outside Collaborators in a Stem Cell Research Projects (Word) – D. Gaudreau/P. Hudobenko

Stem Cell Forms (when awarded, link to ESCRO site) – D. Gaudreau/P. Hudobenko

Stem Cell MTA Cover Sheet (Word) – D. Gaudreau/P. Hudobenko

Representations for Assistance Agreements (PDF)

Certifications and Assurances for Assistance Agreements (PDF)

Workforce Analysis Form (PDF)

Nondiscrimination Certification Form – for DPH Applications (PDF)

Notification to Bidders Form – for DPH Applications (PDF)

Animal Use Forms – A. Pohl

Conflict of Interest Policy and Form (Word) – L. Paplauskas

Federal Express Grant Address Form (Word) – G. Veronesi

Contract Forms

All contract forms related to grants and sponsored programs have moved to the Research Finance website (researchfinance.uchc.edu) and are located under Contracts Related to Grants and Sponsored Programs.