Forms & Applications

NOTICE: All applications are now being scanned for electronic storage. Please do not use colored ink or staples. If highlighting is needed, please use light pastel colors such as yellow.
Approximate time required for the review process:
- Exempt Studies: 7 business days*
- Expedited Studies: 3 weeks*
- Full Review Studies: See IRB Meeting Schedule for deadline - approximately 45 days*
  * NOTE: The review process may take longer if revisions and/or additional information are required. Approval is NOT guaranteed within a definitive timeframe. Submit information well in advance of the anticipated involvement of human participants.
To determine which application form to submit, please see Types of Review.
The forms are available in RTF and DOC. It is recommended that MAC Users utilize the DOC file.

New Studies

EXEMPT STUDIES
- Exemption Determination Form** (RTF) | (DOC)
  **NOTE: Appendices DO NOT need to be completed when submitting an Exemption Determination Form.
- See Consent Form Guidelines, Samples & Templates

Modification Request Form*** (RTF) | (DOC)
***NOTE: This form should be used for Exempt, Expedited & Full Review studies. Since this form does NOT require signatures, the Modification Request Form and other revised documents may be submitted as separate e-mail attachments.
See Consent Form Guidelines, Samples & Templates

Continuing Progress Report (CPR) forms are NOT placed on-line. The CPR Form is sent as an e-mail attachment to the principal investigator 75 days and 45 days prior to the study's approval expiration date.
Co-investigators, Project Coordinators and Advisors, if the principal investigator is a student, are copied on the e-mail notification; however, ONLY the principal investigator will receive the attachment.

Authorization to Use & Disclose Protected Health Information for Research Purposes (RTF) | (DOC)
Waiver of Individual Authorization for Disclosure of Protected Health Information (RTF) | (DOC)
Letter to Revoke Authorization (RTF) | (DOC)
Data Use Agreement for Research 45 CFR 164.514(e) (RTF) | (DOC)
Data Collection for Reviews Preparatory to Research 45 CFR 164.512 (RTF) | (DOC)
HIPAA De-Identification Certification (RTF) | (DOC)
HIPAA Disclosure Tracking Form (RTF) | (DOC)
Research on Decedent's Information (RTF) | (DOC)
HIPAA Consent Form Wording (RTF) | (DOC)

SOP on Reporting of Unanticipated Problems Involving Risks to Participants or Others (RTF)
Problem Report Form (RTF) | (DOC)
Problem Accumulative Tracking Log (RTF) | (DOC)
Non Reportable External Event Report Form (RTF) | (DOC)
Other Event/Problem Accumulative Tracking Log (RTF) | (DOC)

Project Close Out Report for Research Involving Human Participants (RTF) | (DOC)