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View Alphabetical List of Forms
OPRS Going Green: instructions for printing double sided documents.
OPRS accepts and encourages double-sided printing of certain materials.Here are the requirements:
- Each set of documents must begin on a new page. For example, Page 1 of Appendix B cannot begin on the reverse side of the last page of Appendix U.
- Documents that cannot be double-sided:
- Original consent forms
- Authorizations
- Recruitment materials, and
- Any document that requires an IRB Approval Stamp
- Also, the number of copies has been reduced:
- Expedited Review: one original and one copy
- Convened Review: one original and 20 copies
| UIC | Version, Date | Form |
Instructions
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| IRB Review Applications | ||||
| Amendments | v3.3, 6/24/11 | |||
| Appendix A1 - Use of Drugs or Biologic Products in Research | v4.0 6/29/09 | -- |
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| Appendix A2: Use of Medical Devices |
v4.1 10/26/11 | |||
| Appendix B - Involving Children as Subjects in Research | v3.1, 4/1/09 | -- |
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| Appendix C - Involving Prisoners as Subjects in Research | v6.2, 9/24/08 | -- |
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| Appendix D - Databases/DNA/Tissues/Sample Banks | v5.0 | -- |
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| Appendix E - Drug Study Registration Form | v4.2 | -- |
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| Appendix F - Unit/Departmental Review Committee | v2.1 | -- |
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| Appendix G - Clinical Research Center (CRC) | -- |
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| Appendix H - HIPAA Compliance Application | v4.0, 1/12/11 | -- |
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Appendix I - Use of International Performance Sites for Human Subject Research |
v1.0 | -- |
||
| Appendix J - Debriefing for Research Involving the Use
of Deception |
v2.0, 6/22/09 | -- |
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| Appendix K - Performance Sites | v1.3, 6/13/08 | -- |
||
| Appendix L1 - Institutional Review Board (IRB)/Independent Ethics Committee (IEC) Authorization Agreement | v1.1, 5/29/09 | -- |
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| Appendix L2 - Individual Investigator | v1.0, 8/3/07 | -- |
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| Appendix M - Research Data Security | v1.0, 1/5/11 | Word | -- | |
|
v1.0, 9/11/08 | -- |
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|
v1.0, 9/11/08 | -- |
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| Appendix P - Additional Co-Investigators/Key Research Personnel | v3.2, 6/24/08 | -- |
||
| Appendix S - Use of School Classroom as a Performance
Site for Human Subject Research |
v1.0 | -- |
||
| Appendix U - Research Involving Pregnant Women, Human Fetuses, and neonates | v1.0, 2/16/09 | |||
|
v1.1, 4/3/09 | -- |
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| Appendix Z - Additional Funding Sources for Human Subjects Research | v2.2, 4/27/10 | -- |
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| Claim of Exemption | v5.1, 6/24/11 | |||
| Continuing Review UPDATED! | v3.4, 1/30/12 | |||
| Determination of Whether an Activity Represents Human Subjects Research | v2.0, 10/16/08 | -- |
||
| Development/Center/Training Grant Application | v1.0 | |||
| Event Requiring Prompt Reporting to the Institutional Review Board | v2.1, 1/31/11 | |||
| Final Research Report | v1.0 | |||
| Initial IRB Review Social and Behavioral Sciences UPDATED! | v4.3, 1/30/12 | |||
| Initial IRB Review Health and Biological Sciences | v4.5, 6/24/11 | |||
| Protocol Exception | v2.0, 8/20/08 | -- |
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| Informed Consent Templates - Guidance | ||||
| Assent to Participate in Research | 10/29/99 | -- |
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| Authorization to Use and Disclose Health Information - English | v2.9, 3/13/07 | -- |
||
| Authorization to Use and Disclose Health Information - Spanish | v2.9, 3/13/07 | -- |
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| Authorization to Use and Disclose Psychotherapy Notes | v1.0, 3/7/03 | -- |
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| Biomedical Consent for minimal-risk research with HIPAA elements | v2.0, 8/13/07 | |||
| Biomedical Research - English |
10/08/09 | |||
| Biomedical Research - Spanish | 10/08/09 | -- |
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| Behavioral Research - English | 10/08/09 | |||
| Behavioral Research - Spanish | 10/08/09 | -- |
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| Consent for Use of a Humanitarian Use Device (HUD) Template | 6/29/09 | -- |
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| HIPAA drop-in language for consent | v3.4, 3/13/07 | -- |
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| HIPAA drop-in language for consent -Spanish | v3.4, 3/13/07 | -- |
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| Short form for persons who do not read English | v2.6, 1/22/07 v2.6, 8/22/07 v2.6, 8/22/07 v2.6, 8/22/07 v2.6, 8/22/07 v1, 11/8/07 |
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| Contracts for Limited Data Sets | ||||
| Internal Data Use Agreement | v2.0 | -- |
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| External Data Use Agreement | v2.0 | -- |
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| Requesting Continuing Education (CE) Credit | ||||
| Departmental CE Request |
v3.1, 3/10/08 | -- |
||
| Departmental CE Attendance List | v2.2, 6/10/08 | -- |
||
| Individual CE Request | v3.1, 6/10/08 | -- |
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| RiSCWeb Access and Directory Listing | ||||
| Designate RiSCWeb Access for Active Protocols to Research Personnel | v1.0, 7/30/07 | -- |
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| Research Directory Listing | v1.0, 1/6/09 | |||
| Emergency Use of an Investigational Drug/Biologic/Device | ||||
|
v2.0, 6/8/08 | |||
|
v1.0, 7/25/08 | |||
Independent Physician Certification: Emergency Use Of A Test Article Without Informed Consent |
v1.0, 6/9/08 | |||
| Consent for Emergency Use of an Investigational Drug/Biologic/Device Template | ||||
| For all JBVAMC related information, please click on the new Research at JBVAMC button on the left. | ||||
| Federal Drug Administration (FDA) Forms | Form |
Instructions |
||
| Humanitarian Use Device Application | v2.0, 6/23/09 | |||
| Consent for Use of a Humanitarian Use Device (HUD) Template | 6/29/09 | |||
| 1571 - Investigational New Drug Application |
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| 1572 - Statement of Investigator | ||||
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