Institutional Review Board for Health Sciences Research (IRB-HSR)

Submissions

Forms

Age of Majority Addendum Aggregate Review Form Closure Form for Grants Closure Form for Protocols Consent Addendum: Adult or Minor Consent Addendum: Prisoner Consent Short forms for non-English Speaking Subjects Copy Request Form DSMB Charter Template Data Use Agreement with Instructions to PI Debriefing Script For Deception Or Incomplete Disclosure Determination of Human Subjects Research Form Determination of UVa Agent Form Document Submission Form Emergency Use Notification to IRB-HSR Exit Checklist Genomic Data Sharing Submission Certification Request Form Grant Information Form HIPAA Authorization- Stand Alone HIPAA Authorization - Stand Alone: Spanish HUD Patient Information Form International Consent Form Template Minor Deviation Log Modification Forms Medical Records Request Form MRI Dry Run Consent Template Non-UVa Batch AE Submission Form Prescreening Document / Screening Log / Enrollment Log Post Debrief Release Form for Deception Studies Pregnant Partner Addendum Template Protocol Information Form- Humanitarian Use Device Protocol Deviation Protocol Exception Reporting Form Public Data Set Nomination Form Relying Site Protocol Deviation Exception Reporting Form Relying Site Serious Adverse Event Reporting Form Relying Site Unanticipated Problem Report Form Routing Form SOM Form:  Determination of Capacity to Consent Sponsor Addition Form Unaffiliated Investigator Agreement - English Unaffiliated Investigator Agreement - Spanish Unanticipated Problem Report Form New UVa Researcher Information Form Tip: If the pagination in Microsoft Word documents appears incorrect (ex: page 1 of 1, page 2 of 2), click on Print Preview while in the document. This forces Microsoft Word to reset the total page counter (ex: page 1 of 2, page 2 of 2).