IRB Forms

Required for ALL submissions

Project Submission ChecklistDOWNLOAD
Research & Development Information System Project Data Sheet (RDIS)DOWNLOAD
Abstract GuidelinesDOWNLOAD
Prospectus of Research StudyDOWNLOAD
Research Protocol Safety SurveyDOWNLOAD
Impact Estimation Worksheet -PharmacyDOWNLOAD
Impact Estimation Worksheet- PathologyDOWNLOAD
Impact Estimation Worksheet- RadiologyDOWNLOAD
Research Data Inventory ToolDOWNLOAD
Inclusion/Exclusion Criteria ChecklistDOWNLOAD

Additional Forms: Depending on your study

Application for IRB Review-SupplementDOWNLOAD
Guidelines for Narrative Description of Proposed ResearchDOWNLOAD
VA Research Consent (ICF)DOWNLOAD
HIPPA AuthorizationDOWNLOAD
HIPAA RevocationDOWNLOAD
Investigational Drug Information RecordDOWNLOAD
Waiver of Documentation of Informed ConsentDOWNLOAD
Waiver of HIPPA AuthorizationDOWNLOAD
Waiver or Alteration of the Informed Consent ProcessDOWNLOAD
Investigator Device Plan/Device InformationDOWNLOAD
Research Service Data Use and Security PlanDOWNLOAD
HIPAA Authorization - Physician’s ReferralDOWNLOAD
HIPAA Revocation - Physician’s ReferralDOWNLOAD
External Study Monitor Visit ReportDOWNLOAD

Initial Submissions

Research & Development Information System Project Data Sheet (RDIS)DOWNLOAD
Abstract GuidelinesDOWNLOAD
Prospectus of Research StudyDOWNLOAD
Application for IRB Review (Full and Expedited Review Only)DOWNLOAD
IRB Exempt Eligibility Determination Form (IRB Exempt Only)DOWNLOAD
Research Data Inventory ToolDOWNLOAD
Guidelines for Narrative Description of Proposed ResearchDOWNLOAD
Research Protocol Safety SurveyDOWNLOAD
Impact Estimation Worksheet- PharmacyDOWNLOAD
Impact Estimation Worksheet- PathologyDOWNLOAD
Impact Estimation Worksheet- RadiologyDOWNLOAD
Waiver of Documentation of Informed ConsentDOWNLOAD
Waiver of HIPPA AuthorizationDOWNLOAD
Waiver or Alteration of the Informed Consent ProcessDOWNLOAD
DMAPs – Non-VA SponsoredDOWNLOAD
DMAPs- Non-SponsoredDOWNLOAD

QA/QI

QA/QI Research DeterminationDOWNLOAD

Study Closure Submission

Research & Development Information System Project Data Sheet (RDIS)DOWNLOAD
Abstract GuidelinesDOWNLOAD
Status of Active Study ApplicationDOWNLOAD

Deviation Submission

DeviationDOWNLOAD

Continuing Review Submission - Required for all Submissions

Research & Development Information Sheet (RDIS)DOWNLOAD
Abstract GuidelinesDOWNLOAD
Research Protocol Safety SurveyDOWNLOAD
Inclusion/Exclusion Criteria ChecklistDOWNLOAD
Status of Active Study ApplicationDOWNLOAD

Modification Submission

Request for Modification of Approved ProjectDOWNLOAD
VA Research Consent (ICF)DOWNLOAD
HIPAA AuthorizationDOWNLOAD
HIPAA RevocationDOWNLOAD
If Requesting: HIPAA RevocationDOWNLOAD
HIPAA Authorization - Physician’s ReferralDOWNLOAD
HIPAA Revocation - Physician’s ReferralDOWNLOAD

Serious Adverse Events

Non-Local SAEDOWNLOAD
Local SAEDOWNLOAD

IRB Personnel Changes

Personnel ChangeDOWNLOAD