PURPOSE: Gulf War Illness (GWI) is a poorly understood illness that impacts about a third of Veterans who were deployed to the Gulf Region during the 1990-1991 Gulf War (GW). Treatment of GWI has focused on alleviating symptoms while the underlying cause/s remains unclear. The Department of Veteran Affairs (VA) initiated a partnership with the National Institutes of Health (NIH) to better understand GWI, with VA leading recruitment and screening of GW Veterans for referral to the NIH for deep phenotyping. The VA developed a remote screening process for clinical data capture for case adjudication and referral. The purpose of this poster is to describe this novel collaboration with the VA and NIH, that offers national enrollment of GW Veterans. METHODS: VA Central IRB approval was acquired on a 5-year, multi-site remote clinical research study. Tiered recruitment strategy focused on data use agreements with established GW research cohorts that enabled assessment of eligibility using an automated prescreening within the VA Informatics and Computing Infrastructure for targeted outreach. Veterans from the GW community may also enroll. GW Veterans were then reviewed through a decentralized, remote screening pipeline, consisting of electronic informed consent, online questionnaires, home-based laboratory sample collection and vital signs, remote clinical review of electronic health records, and telehealth evaluations including remote medical exams, neuropsychological assessments, and military exposures histories. Data was also supplemented by objective exposure information from the Individual Longitudinal Exposure Record. Eligibility reviews were completed at key intervals. Clinical study oversight and interagency communication was facilitated through an automated Power BI dashboard secured behind the VA-firewall. The entirety of data collection culminated with a case adjudication process designed to review GW Veterans in the context of a case definition that restricts interindividual variability. RESULTS: The study has successfully enrolled 75 GW Veterans, with an initial 5-10% adjudicated for referral to NIH. This study marks the novel collaboration between the VA, NIH and other federal (DoD), academic, and outside vendors (ExamOne, Quest), with an enrollment rate of 78% and withdrawal rate of 5%. The emphasis on the Veteran experience within the study is a priority. This study uniquely offers a constructed summary of results that Veterans can choose to add to their medical records and/or discuss with their local providers via teleconsultation. Ineligible Veterans are provided with resources and an anonymous satisfaction survey to ensure a high-quality experience. CONCLUSIONS: This million study marks the inaugural collaboration between the VA and NIH, and other partners including the DoD, with the potential to inform and shape future policy decisions related to Veteran’s health and sets a precedent for future large-scale funding efforts. Remote participation that leverages a range of resources and services offers Veterans access to research that is important for those experiencing chronic illnesses. Our approach of leveraging existing cohorts and community involvement, in combination with thorough screening methodology, has proven effective in remote, high-throughput, decentralized research operations with national scope, in a traditionally challenging-to-recruit cohort of Veterans.