The following is a list of forms that will need to be completed during your participation in the SRTP.

Participant Information Form
Information submitted in the Participant Information form provides important information to the SRTP staff.

Submit a Proposal
Please use this form to submit your research project's proposal.

Submit an Abstract
Please use this form to submit your research project's abstract.

Submit a Presentation
Please use this form to submit your research (PowerPoint) presentation.

Statement of Appointment
Please download and complete the Statement of Appointment form (PDF). Please deliver the completed form to Program Administrator..

Confidentiality Agreement
As a member of the Vanderbilt community, you may have access to confidential information. Please download and complete the VUMC Confidentiality Agreement, sign, and deliver to Program Administrator.

HIPAA Training
The Health Insurance Portability and Accountability (HIPAA) Act regulations require that ALL individuals working at Vanderbilt, i.e., faculty staff, student, volunteer, etc., receive HIPAA training on VUMC privacy policies and practices. Please review the SRTP HIPAA Training FAQ and the additional HIPAA information contained at the Vanderbilt HIPAA References and Resources website. You will then need to complete a short quiz indicating that you have read and are familiar with HIPAA and understand general HIPAA policy.

Standards of Conduct
Vanderbilt requires ALL individuals to be aware of the Standards of Conduct. Please download and review the Standards of Conduct brochure. After reviewing the brochure, you will need to complete a brief online form acknowledging receipt of the brochure, and that you understand that you are responsible for knowing and adhering to the Standards of Conduct.

HIPAA Test
This brief test allows you to confirm your understanding of HIPAA requirements.

Please deliver your completed forms to:

Student Research Training Program
Division of Diabetes, Endocrinology, and Metabolism
Vanderbilt University Medical Center
Room 7465 Medical Research Building IV
2213 Garland Avenue
Nashville, TN 37232-0475
Phone: 615-936-1625
E-mail: stu.res@vanderbilt.edu

The Medical Student Summer Research Training Program is supported by the Vanderbilt Short Term
Research Training Program for Medical Students (NIH grant DK007383) and the Vanderbilt Diabetes
Research and Training Center (NIH grant DK20593).