PAMQuIP Subject Remuneration LogTrack all remuneration obtained by research staff and distributed to subjects

Principal Investigator       Date of study approval      

Study Title      Study # HM      

VCU policy requires that Principal Investigators (PIs) track payments provided to research subjects. After receipt of the gift card/cash/voucher, the individual who is responsible for the safe keeping of remuneration should log them on this form. When remuneration is distributed, the date, subject ID#, if the voucher/card/cash was given to the parent or the child, should be noted on the form, and signed/initialed by parent/subject and by study staff.

Date Received Gift Card ID

Card/Voucher/ Cash Amount

Date Given to Parent/Subject

Subject ID# of Recipient

Parent or Subject Given Remuneration

Parent or Subject Initials/Signature

Staff Initials

                                   

                                   

                                   

                                   

                                   

                                   

Adapted with Permission from Boston Children’s Hospital 2013 2018 Version Page _____ of _____

                                   

                                   

                                   

                                   

                                   

                                   

Adapted with Permission from Boston Children’s Hospital 2013 2018 Version Page _____ of _____