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Office of Research & Development

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Instructions for Listing Available Equipment

  • 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).

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.



Questions about the R&D website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.