Instructions to Request Available Equipment

Research Offices/R&D Coordinators wishing to request equipment listed on this website must submit a completed online editable version of VA Form 10-1274a (Inquiry on Availability of an Instrument from VA REQUIP) electronically to the REQUIP Coordinating Officer at Requip@va.gov.

• An e-mail directly from the ACOS' computer containing an electronic signature or typed name and title is acceptable signature on VA Form 10-1274a.
• 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 10-1274a directly to the REQUIP mailbox by clicking the "E-mail Button" at the bottom of the form.
• A separate VA Form 10-1274a must be submitted for each instrument.

Links to Forms

Note: Word documents not "form-fill"; must be printed, completed, and sent as PDF file attachments to REQUIP@va.gov.

• Local safety officer/industrial hygienist checklist (32 KB, MS WORD)
• Biomedical engineer checklist (32 KB, MS WORD)

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 go to the Intranet version of this page at http://vaww.research.va.gov/requip/request-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.