IRB FORMS

Because of technical difficulties the IRB forms are not available for download at this time.  Please review the list below and email the IRB office the names of the forms needed.  We will forward to you by email.  The office cannot accept forms that are not locked with the password assigned by our office, therefore any such forms will be returned to the site for correction.


Amendment Form:  Submit a request to make any change to a study.

Application Form:  Use this form for initial submission of exempt, expedited or convened reviews.

Continuing Review Form:  Request continuation of a study that was approved as Expedited (EX) or Full Board (FB).

Exempt Study Update Form:  Update the IRB on the status of an Exempt (XX) study.

Investigator Assurance:  Each investigator on the study must have a current assurance on file.  Assurances are valid for three years.  Print, sign, scan and upload forms to your electronic submissions.

IRB Fee Waiver:  Request a waiver of fees for a study reviewed by the convened Board.

New Protocol Submission ChecklistTo help ensure all documents are submitted.

Notification of Closure Form:  Close a completed or terminated study.

LOCAL - Serious Adverse Event: Submit an SAE for any subject enrolled at a site approved by the EVMS.

NON-LOCAL - Serious Adverse Event:  Submit an SAE for subjects enolled at other sites in a multi-center study.

Use of PHI Application:  Request access to PHI for protocol preparation, to identify whether a research study can be developed, or to identify possible subjects for a research study.

Waiver of Consent Request: Request that the IRB grant a waiver of consent so that subjects do not have be consented.  This is typically done for a chart review of existing data but has other uses as well.  Applies only to studies reviewed by the convened Board or classified as expedited by a sub-committee.

Waiver of Authorization for Use of PHI:  Request that the IRB waive the requirement for patient authorization to access PHI for research purposes.