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Vice President for Research & Development

Institutional Review Board (IRB) Forms & Templates

Forms

IRB Checklist / Application (RA-108) - 11-pt summary NOT required with new form

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Continuation Report (RA-109) - Approved no more than 30 days prior to expiration

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Amendment Request (RA-110)

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Permission to Gather Personal Health Information (HIPAA)
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Courses Involving Students' Investigations: Research Methods Course Form

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Statement of Confidentiality, signed by PI when using online survey software - submit with IRB application  Word Word
Notification of Unanticipated Problems (adverse incident report) Word Word


Templates & Examples

Informed Consent (45 CFR 46.117)

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Parental Permission (45 CFR 46.408(b))

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Minor's Assent (45 CFR 46.408(a))
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Limits of Confidentiality

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Office of the Vice President

Research & Development

University Hall 116

(406) 243-6670

Fax: (406) 243-6330