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Human Investigation Form 2026

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The document is a Human Seoul Virus Exposure Questionnaire designed to assess potential exposure to the Seoul virus through contact with rats. It includes sections for demographic information, general rat exposure questions, specific inquiries about contact with rats from facilities with confirmed infections, and an illness history section. The questionnaire aims to gather detailed information on the individual's interactions with rats, any symptoms experienced, and medical care sought.

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Click ‘Get Form’ to open the Human Investigation Form in the editor.
Begin by filling out the Demographics section. Enter your Patient ID, Facility Name, Date of Interview, and personal details such as Name, Sex, DOB, Age, Address, Phone Number, and Email Address.
Proceed to the General Rat Exposure Questions. Select your responses regarding glove usage when handling rats and their bedding. If applicable, specify the type of gloves used.
Answer questions related to exposure from facilities with confirmed Seoul virus infections. Provide details for each contact event including date and setting.
Complete the Illness History section if you have experienced any illness since the effective date. Document symptoms and medical care sought.
Review all entries for accuracy before submitting the form through our platform.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (80 Votes)

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Is NIH part of PHS?

The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nations medical research agency making important discoveries that improve health and save lives.

What is phs nih?

The Public Health Service (PHS) Human Subjects and Clinical Trials form is required for most National Institutes of Health (NIH) applications. It collects information on proposed human subjects research, clinical research, and/or clinical trials.

What is 2.1 conditions or focus of study?

2.1: Conditions or Focus of the Study: At least 1 entry is required, and up to 20 entries are allowed (enter each entry on its own line). Each entry is limited to 255 characters. Identify the name(s) of the disease(s) or condition(s) you are studying, or the focus of the study.

What is an example of informed consent for human subjects?

CONSENT STATEMENT: I, , hereby give my consent to participate in the research study entitled Perceptions of Charismatic Speech. I have read the above information and am aware of the potential risks and complications.

What does PHS stand for in grants?

This Policy applies to all research funded or proposed for funding by the Public Health Service of the U.S. Department of Health and Human Services (PHS), including the National Institutes of Health (NIH).

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What is the PHS policy definition of an animal?

Federally funded research is guided by two key definitions: The PHS Policy, which applies to all PHS-funded activities involving animals, defines animals as any live, vertebrate animals used or intended for use in research, research training, experimentation, or biological testing or for related purposes.

What is NIH exemption 4 human subjects?

Exemption 4 - Research involving the collection or study of existing data, documents, records, pathological or diagnostic specimens; if these sources are publicly available or if the information is recorded in such a manner that subjects cannot be identified.

What is the PHS in healthcare?

The Division of Public Health Services (PHS) is responsible for public health services programs and policies. PHS works with Departmental components, particularly those that fund the provision of direct care to vulnerable populations, including primary care, clinical preventive services, and related support services.

Human Investigation Form 2026

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