Forms

HRRC Menu

All forms are in Word Format

HRRC Application, Form A
Use Form A to submit an initial application for Committee review of a proposed research project.

Continuing Review, Form B
Use Form B to: (1) request a continuing review, (2) request amendments or revisions to an HRRC-approved project, OR (3) report unanticipated problems, adverse events or complaints.

Research Project Closure, Form F
Use Form F to notify the HRRC when your research project is completed.

Report Inquires, Form C
Use Form C to report inquiries, comments and/or concerns from human research subjects, the community, and others.

Individual Investigator Agreement, Form D
Form D provides a permissible mechanism under which an institution holding an Office for Human Research Protections (OHRP)-approved Federalwide Assurance (FWA) (hereafter referred to as the assured institution) may extend - for one or more research protocols - the applicability of its FWA to cover two types of collaborating individual investigators: collaborating independent investigators and collaborating institutional investigators.

Assent Template, Form E
Form E is meant to help investigators in preparing assent forms; the use of this template is not required.

Confidentiality Certificate, Form G
At the discretion of the Chairperson or her/his designee, persons may be permitted to attend/observe HRRC meetings as guests.

Supplement 1
Use Supplement 1 if you are requesting Exempt Review. Be sure to attach this supplemental form to the completed "Application Form A".

Supplement 2
Use Supplement 2 if you are requesting Expedited Review. Be sure to attach this supplemental form to the completed "Application Form A".

Conflict of Interest Disclosure Statement, Form H

Conflict of Interest Disclosure Supplement, Form H Supplement
Use Form H and Form H Supplement to disclose or deny any financial interest(s) in the research project.