VA Form 10-1314 Hsr&d Carer Development Awardee Annual Progress Report

VA Form 10-1314 or the "Hsr&d Carer Development Awardee Annual Progress Report" is a form issued by the United States Department of Veterans Affairs.

The form was last revised on January 1, 2002 - an up-to-date fillable PDF VA Form 10-1314 down below or find it on the Veterans Affairs Forms website.

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DATE COMPLETED
Health Services Research and Development Service
Career Development Awardee
ANNUAL PROGRESS REPORT
TO BE COMPLETED BY THE AWARDEE
Response should only include updates, changes and activities since the last report. If additional space is needed, continue onto a separate
sheet. Attach reprints (if available) of any publications listed. (Please type or print.)
AWARDEE NAME, DEGREES (Print)
LOCATION OF PRIMARY OFFICE AND WORK SITE
ROUTING SYMBOL
(City, State)
VA TITLE
VA MEDICAL CENTER
ACADEMIC RANK, DEPARTMENT AND AFFILIATION
E-MAIL ADDRESS
TELEPHONE NUMBER
FAX NUMBER
1. SPECIFY ANY CHANGES TO MENTORING, RESEARCH OR CAREER PLANS, INTEREST OR FOCUS SINCE LAST REPORT.
2. LIST ALL NON-RESEARCH ACTIVITIES FOLLOW ED BY PER CENT OF AW ARDEES TIM E COM M ITM ENT TO EACH
Non-Research Role or Activity
%Time
Non-Research Role or Activity
%Time
A
C
B
D
3. TRAINING SINCE LAST REPORT (formal courses, seminars, data sessions, lab meetings, journal clubs, lecture series, etc.)
Training Received
Time Period
Training Received
Time Period
A
D
B
E
C
F
4. PARTICIPATION IN NATIONAL OR INTERNATIONAL SCIENTIFIC MEETINGS
Meeting
Date
Meeting
Date
A
C
B
D
5. PUBLISHING EFFORT SINCE LAST REPORT, LIST ARTICLES SUBMITTED (attach extra page if necessary), IN-PRESS, OR PUBLISHED
Name of Journal
Peer Review
1st or 2nd Author?
Topic of Article
Publication Date or Status
Y
N
Y
N
A
Y
N
Y
N
B
Y
N
Y
N
C
Y
N
Y
N
D
Y
N
Y
N
E
Y
N
Y
N
F
6. SPECIAL ACHIEVEMENTS OR RECOGNITION SINCE LAST REPORT
Please refer to the Health Services Research and Development Service Capacity Building Handbook, for a complete description of the Career
Development Program and instructions for preparing annual reports.
10-1314
VA FORM
Page 1 of 2
JAN 2002
DATE COMPLETED
Health Services Research and Development Service
Career Development Awardee
ANNUAL PROGRESS REPORT
TO BE COMPLETED BY THE AWARDEE
Response should only include updates, changes and activities since the last report. If additional space is needed, continue onto a separate
sheet. Attach reprints (if available) of any publications listed. (Please type or print.)
AWARDEE NAME, DEGREES (Print)
LOCATION OF PRIMARY OFFICE AND WORK SITE
ROUTING SYMBOL
(City, State)
VA TITLE
VA MEDICAL CENTER
ACADEMIC RANK, DEPARTMENT AND AFFILIATION
E-MAIL ADDRESS
TELEPHONE NUMBER
FAX NUMBER
1. SPECIFY ANY CHANGES TO MENTORING, RESEARCH OR CAREER PLANS, INTEREST OR FOCUS SINCE LAST REPORT.
2. LIST ALL NON-RESEARCH ACTIVITIES FOLLOW ED BY PER CENT OF AW ARDEES TIM E COM M ITM ENT TO EACH
Non-Research Role or Activity
%Time
Non-Research Role or Activity
%Time
A
C
B
D
3. TRAINING SINCE LAST REPORT (formal courses, seminars, data sessions, lab meetings, journal clubs, lecture series, etc.)
Training Received
Time Period
Training Received
Time Period
A
D
B
E
C
F
4. PARTICIPATION IN NATIONAL OR INTERNATIONAL SCIENTIFIC MEETINGS
Meeting
Date
Meeting
Date
A
C
B
D
5. PUBLISHING EFFORT SINCE LAST REPORT, LIST ARTICLES SUBMITTED (attach extra page if necessary), IN-PRESS, OR PUBLISHED
Name of Journal
Peer Review
1st or 2nd Author?
Topic of Article
Publication Date or Status
Y
N
Y
N
A
Y
N
Y
N
B
Y
N
Y
N
C
Y
N
Y
N
D
Y
N
Y
N
E
Y
N
Y
N
F
6. SPECIAL ACHIEVEMENTS OR RECOGNITION SINCE LAST REPORT
Please refer to the Health Services Research and Development Service Capacity Building Handbook, for a complete description of the Career
Development Program and instructions for preparing annual reports.
10-1314
VA FORM
Page 1 of 2
JAN 2002
7. NEW PROJECTS AND PROPOSALS SINCE LAST REPORT (Attach completed VA Forms 10-1313-7 and 10-1313-8)
Project Number
Role
Source
Budget
Status
A
B
C
D
E
F
8. PRESENTATIONS AND INVITED LECTURES SINCE LAST REPORT
Description
Occasion
Location
Date
A
B
C
D
E
F
(% time, days/week, days/month, etc.)
9 . NAM ES OF M ENTORS AND DESCRIPTION OF LEVEL OF INTERACTIONS WITH AWARDEE
Primary Mentor
Secondary Mentor
Tertiary Mentor
(Signature of Awardee)
10. SIGNATURE
DATE
(I have reviewed the awardees progress and found it satisfactory.)
11. NAME AND SIGNATURE OF AWARDEE' S ACOS FOR RD
DATE
12. COMMENTS (Awardee or ACOS for RD)
10-1314
VA FORM
Page 2 of 2
JAN 2002

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