If you cannot access the hyperlinks below,

visit http://grants.nih.gov/grants/peer/critiques/rpg.htm.

Application #:

Principal Investigator(s):

Overall Impact

Overall Impact Please limit text to ¼ page
Strengths
Weaknesses

Scored Review Criteria

1. Significance Please limit text to ¼ page
Strengths
· 
Weaknesses
· 
2. Investigator(s) Please limit text to ¼ page
Strengths
· 
Weaknesses
· 
3. Innovation Please limit text to ¼ page
Strengths
Weaknesses
4. Approach Please limit text to ¼ page
Strengths
Weaknesses
5. Environment Please limit text to ¼ page
Strengths
Weaknesses

Additional Review Criteria

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The following review criteria are not scored individually, but should be considered when determining the overall impact/priority score.

Protections for Human Subjects
Click Here to SelectAcceptable Risks and/or Adequate ProtectionsUnacceptable Risks and/or Inadequate ProtectionsNot Applicable (No Human Subjects)
Comments (Required Unless Not Applicable):
· 
Data and Safety Monitoring Plan (Applicable for Clinical Trials Only):
Click Here to SelectAcceptableUnacceptableNot Applicable (No Clinical Trials)
Comments (Required Unless Not Applicable):
o 
Inclusion of Women, Minorities and Children Applicable Only for Human Subjects Research
Click Here to Select Gender CodeG1A - Both Genders, AcceptableG1U - Both Genders, UnacceptableG2A - Only Women, AcceptableG2U - Only Women, UnacceptableG3A - Only Men, AcceptableG3U - Only Men, UnacceptableG4A - Gender Unknown, AcceptableG4U - Gender Unknown, Unacceptable
Click Here to Select Minority CodeM1A - Minority and Non-minority, AcceptableM1U - Minority and Non-minority, UnacceptableM2A - Only Minority, AcceptableM2U - Only Minority, UnacceptableM3A - Only Non-minority, AcceptableM3U - Only Non-minority, UnacceptableM4A - Minority Representation Unknown, AcceptableM4U - Minority Representation Unknown,UnacceptableM5A - Only Foreign Subjects, AcceptableM5U - Only Foreign Subjects, Unacceptable
Click Here to Select Children CodeC1A - Children and Adults, AcceptableC1U - Children and Adults, UnacceptableC2A - Only Children, AcceptableC2U - Only Children, UnacceptableC3A - No Children Included, AcceptableC3U - No Children Included, UnacceptableC4A - Children Representation Unknown, AcceptableC4U - Children Representation Unknown,Unacceptable
Comments (Required Unless Not Applicable):
· 
Vertebrate Animals
Click Here to SelectAcceptableUnacceptableNot Applicable (No Vertebrate Animals)
Comments (Required Unless Not Applicable):
· 
Biohazards
Click Here to SelectAcceptableUnacceptableNot Applicable (No Biohazards)
Comments (Required Unless Not Applicable):
· 
Resubmission Please limit text to ¼ page
Comments (if applicable):
· 
Renewal Please limit text to ¼ page
Comments (if applicable):
· 
Revision Please limit text to ¼ page
Comments (if applicable):
· 

Additional Review Considerations

The impact/priority score should not be affected by the following considerations.

Budget and Period of Support
Click Here to SelectRecommend as RequestedBudget Modifications Recommended (in amount/time)
Recommended budget modifications or possible overlap identified:
· 
Select Agents
Click Here to SelectAcceptableUnacceptableNot Applicable (No Select Agents)
Comments (Required if Unacceptable):
· 
Applications from Foreign Organizations
Click Here to SelectJustifiedUnjustifiedNot Applicable (No Foreign Organizations)
Comments (Required Unless Not Applicable):
· 
Resource Sharing Plans
Click Here to SelectAcceptableUnacceptableNot Applicable (No Relevant Resources)
Comments (Required if Unacceptable):
· 

Additional Comments to Applicant

Additional Comments to Applicant (Optional)
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