Forms and Surveys

No More PDFs!

We have migrated to REDCap for our common case review requests. If you need to open a case, see the links below and/or the respective tabs to the left to access our all-new online REDCap Surveys. These will take the place of all prior PDF form requests.

You no longer need to fill out and submit the old forms. Once you complete and submit the appropriate survey, we will automatically receive a notification and will begin review of your case. You will always receive a response from us denoting approval or request for more information. If you need to submit an Export Compliance approval as your next step, please use the correspondence we will send to you after we review your survey responses.

If there are any concerns, questions, or issues with the new online surveys, please contact us and we will address these promptly. If there are any features or clarifications you think would make for a better experience, please let us know these also.


Important Note:

Please submit your surveys at least 10 business days prior to shipping, departing for international travel, conducting international research, or bringing a foreign colleague/visitor to campus.


Restricted Party Screening Request (RPS) REDCap survey

Submit this survey to request a Restricted Party Screening*.

*Certain individuals and entities are listed on various domestic and internationally published or Government-maintained denied/restricted/blocked parties lists ("DPL"). We are prohibited from accepting funds, travelling to, supporting (financially or intellectually), or doing business with denied or restricted parties without an authorized license or appropriate, approved exemption. A RPS/DPL search will provide an assessment of whether any individual, entity, company, institution, organization, or group you may potentially interact with is on any of these lists.

Once we run the details you provide through RPS, we will let you know the result and provide a copy of the screening results upon request.


Visa Deemed Export Questionnaire (VDEQ) REDCap survey

Submit this survey when hiring a foreign national to ensure compliance with I-129 rules and other export control regulations.

Instructions


International Travel Questionnaire (ITQ) REDCap survey

Submit this survey to document business-related* travel outside the U.S.

*This includes personal travel when VUMC-owned assets will be taken with you.

TMPs are no longer required for each travel instance. Once submitted, VUMC EC will review your International Travel Questionnaire ("ITQ"), and if a TMP is necessary, you will be contacted.


Pre-Travel Checklist (Int'l Travel with Laptops & Mobile Devices) PDF

Use this as a quick reference to items/devices you are taking with you when you travel outside the U.S.

*This includes personal travel when VUMC-owned assets will be taken with you.


International Visitor Screening (IVS) REDCap survey

Submit this form to document record of a visitor from outside the U.S. (regardless of nationality) to your department, office, lab, etc.

Instructions


International Shipment Review Survey REDCap survey

Submit this survey to document an international shipment (physical export of items and/or information, technology, or data) outside the U.S.
**Note: This is required for ALL international shipments, regardless of whether or not the contents are export-controlled, who they are going to, or where they are going.**


International Collaboration Review Survey REDCap survey

Submit this survey to document any collaboration with foreign persons or entities or when research will be conducted in a foreign country. (If the activity is being formalized or managed by OSP/OCM, you do not need to complete this form.)


PI Lab Pre-Review Survey REDCap survey

Submit this survey to assist VUMC Export Compliance ("VUMC EC") in determining the compliance-related risk level associated with a VUMC laboratory/workspace. 


Restricted Biological Agents PDF

Use this list as general guidance to determine if viruses, bacteria, toxin, fungi, or genetic material in question has export control restrictions.


Restricted Chemicals PDF

Use this list as general guidance to determine if chemicals or families in question have export control restrictions.


End-Use End-User Statement (EUEUS) Word doc

If an international shipment is to a partner/entity without a MTA in place, submit this form in addition to the 'International Shipment Review' survey above.


Export Compliance Checklist REDCap survey

Submit this survey to assist in identifying potential export control-related issues that may need to be addressed before proceeding with certain projects.


Relinquishment Form PDF

Use this form to relinquish VUMC-owned property (such as a laptop, cell phone, tablet, etc.) to become personal property of a foreign beneficiary. Once executed by all 3 parties, the beneficiary takes full ownership including permanent rights of transfer.


Commercial Invoice PDF

Use this form to assist in the documentation of a physical export (shipment) - when necessary - to an international country.

Before the invoice is sent (or any payment is made or received), we are required to vet each entity via restricted party screening.

If after selecting Commercial Invoice, you receive a screen that looks like the below, choose the Download button in the upper right corner and a functional, local copy will be saved to your computer.

download
 


Export Compliance Review Flow Chart PDF

Use this flow chart as general guidance to determine whether or not the research, shipment, export, etc. in question has export control restrictions.


VUMC Export Compliance Flier PDF

This flyer may be printed and posted to assist in providing export compliance awareness for VUMC employees.


U.S. Export Controls Flow Chart PDF

Use this flow chart for a visual aid to assist you in familiarization with the foundation of U.S. Export Controls, regulations, guiding acts, and responsible departments, bureaus, and offices.


Restricted Viruses PDF

Restricted Bacteria PDF

Restricted Toxins PDF

Restricted Fungi PDF

Restricted Genetic Materials PDF

Restricted Vaccines, Immunotoxins & Medical Products PDF

Restricted and Controlled Protective Equipment, BSL-3 or higher equipment, and/or Nucleic Acid Assemblers/Synthesizers & Related Software PDF


If you still need a form?

1. Please do not save a local copy of these forms. In each instance you need one of the forms located above, please revisit our site to ensure you have the latest copy, as export control regulations are subject to change on a frequent basis.

2. Please read each form in its entirety and fill out completely so as not to delay your request. Once completed, save a copy and email the document to export@vumc.org.

3. Keep all export documentation related to each export for five (5) years past the last date of activity regarding your transaction.

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Other form/survey concerns or errors? Contact VUMC EC at (615) 875-7577 for further assistance.

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