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Health and Human Services (HHS, PHS, PSC, & SAMHSA) Forms in Word
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| Form No. | Form Title | Price | Buy Now in Microsoft Word |
Health and Human Services (HHS) |
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HHS-568 Form |
Procedures for Submission of Final Invention Statement |
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HHS-687 Form |
Consent to Sterilization |
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HHS-687-1 Form |
Consent to Sterilization (Spanish Version) |
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HHS-690 Form |
Assurance of Compliance |
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HHS-719 Form |
Request for Copy of the Record(s) in the Case File |
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HHS-720 Form |
Request for Copy of Record(s): Third-Party with the Individual Appellant's Consent |
$9.99 |
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HHS-721 Form |
Individual Appellant's Consent to Third-Party for Copies of the Individual Appellant's Record(s) |
$9.99 |
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HHS-722 Form |
Request for Substitution of Party Upon Death of Party |
$9.99 |
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HHS-723 Form |
Waiver of Right to an Administrative Law Judge (ALJ) Hearing |
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HHS-724 Form |
Request to Correct, Amend, or Delete a Record(s) |
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HHS-725 |
Request for Administrative Law Judge (ALJ) to Review Dismissal by the Qualified Independent Contractor |
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HHS-727 Form |
Extension Request to File a Request for an Administrative Law Judge (ALJ) Hearing |
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HHS-728 Form |
Filing of New Evidence |
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HHS-729 Form |
Response to Notice of Hearing |
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HHS-730 |
Withdrawal of Request for an Administrative Law Judge (ALJ) Hearing |
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HHS-731 Form |
Withdrawal of Waiver of Right to an Administrative Law Judge (ALJ) Hearing |
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HHS-733 |
Identity Verification |
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HHS-734 |
Payment Information Report |
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HHS-T-001 |
Response to Notice of Hearing |
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Public Health Service (PHS) |
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PHS-50 Form |
Application for Appointment as a Commissioned Officer in the US Public Health Service Commissioned Corps |
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PHS-398 Form |
Application for PHS Grant |
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PHS-416-1 Form |
Application for PHS Individual National Research Service Award |
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PHS-416-5 Form |
Research Fellowship Activation Notice |
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PHS-416-7 Form |
Termination Notice NRSA |
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PHS-416-9 Form |
Application for PHS Individual National Research Service Continuation Award |
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PHS-1813 Form |
Reference Request for Applicants to the U.S. Public Health Service Commissioned Corps |
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PHS-2271 Form |
Statement of Appointment of Trainee |
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PHS-2590 Form |
Application for Continuation of a PHS Grant |
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PHS-3734 Form |
Official Statement Relinquishing Interest and Rights in a PHS Research Grant |
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PHS-3734 Form |
Grant Application for Non-Construction Projects |
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PHS-6031 Form |
National Research Service Award |
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PHS-6031-1 |
Annual National Research Service Award |
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PHS-6349 |
Annual Report on Possible Research Misconduct |
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Program Support Center (PSC) |
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PSC-270 |
Student Loan Repayment Plan (Program Support Center (PSC) and PSC-Serviced HHS Components) |
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Substance Abuse and Mental Health Services Administration (SAMHSA) |
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SMA-162 Form |
Application for Certification to Use Opioid Drugs in a Treatment Center |
$9.99 |
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SMA-167 Form |
Notification of Intent to Use Opioid Drugs for Maintenance and Treatment |
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SMA-171 Form |
Prevention Registry |
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SMA-172 Form |
SAMHSA Application for Peer Grant Review |
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