Form 2 Guest Researchers Agreement Form

Special Volunteer and Guest Researcher Assignment (OD)

Attachment 4 Guest Researcher Agreement (2)

Agreement Form

OMB: 0925-0177

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NIH Guest Researcher Program
NIH Guest Researcher Agreement

I, (name) hereby agree in consideration of acceptance by NIH as a Guest Researcher that I will:

  1. Agree to be bound by all provisions of Executive Order 10096, as amended, 45 C.F.R. Part 7 and any orders, rules, regulations or the like issued there under, as if I were a Government employee who conceived an invention or first actually reduced it to practice while at the NIH. I agree to disclose promptly to the appropriate NIH officials, all inventions which I may conceive or first actually reduce to practice during my visit to the NIH, and to sign and execute all papers necessary for conveying to the Government the rights to which it is entitled by virtue of Executive Order 10096, as amended, and this agreement.

  2. Submit publications resulting from work at NIH to be cleared for conformance with NIH’s publication policies.

  3. Waive any and all claims for compensation from the Government of the United States for any services performed incidental to the personal research I am doing, and absolve NIH of any responsibility in case of personal injury or death arising out of those research activities, and/or failure or damage to my experiments or equipment.

  4. While on NIH premises, conform to all applicable administrative instructions and requirements of the Department of Health and Human Services and NIH, including all regulations and procedures concerning conduct, safety, patient care, and animal care.

  5. Agree that I will obtain, prior to the beginning of this assignment, health insurance coverage substantially comparable to that provided by the Federal Employee’s Health Benefits Plan and will have that coverage approved by the host IC.

  6. If not a US citizen or permanent resident, agree to provide evidence of valid non-immigrant status and employment eligibility to the Division of International Services, ORS, for the duration of the assignment.

Please check this box if you will receive a salary or stipend while at NIH that is derived in any way from, or related to, Federal (including NIH) funds (e.g., grants, contracts, training awards). Specify details on a separate page.

_____________________________________ _______________________________________
Guest Researcher’s Signature Date NIH 590-1 (pending) Signature/Date of Outside Employer Responsible Official




File Typeapplication/msword
File TitleNIH SPECIAL VOLUNTEER
AuthorBISHOPE
Last Modified ByCurrie, Mikia (NIH/OD) [E]
File Modified2014-05-07
File Created2014-05-07

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