Institutional Review Board
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Forms

Directions

Each form has specific guidelines to help you properly complete the forms. Please read them before completing the form. Below are general instructions for all the IRB forms:

  • Please read the forms and guidelines carefully!
  • Submit completed forms to irb@memphis.edu* (note: do not submit forms or requested revisions to individual IRB Staff e-mail addresses)
  • Applications that are not completed properly will be returned to the investigator as incomplete and will not be processed.
  • A full review and approval may require 30 to 60 days for processing.
  • The IRB will confirm receipt of your documents via e-mail within three business days.

*Due to a recent change in the IRB mailbox, emails may come back as undeliverable. If this is the case, use the Global Address List to select "Institutional Review Board" and try sending your email again.

 

 Forms

Forms Guidelines Descriptions
Determination Form (DET) None Use this form if you unsure as whether or not your project qualifies as research or if it involves human subjects.
Initial Review Request Form (IRR)

Initial Review Request Guidelines

Use this form for all initial submissions including Exempt, Non-Exempt and Secondary Analysis of Existing Data. For an example of a completed form click here.
Subsequent Event Form (SEF) Subsequent Event Guidelines Use this form for all events that take place after a studies initial approval including Amendments, Continuations, Adverse Events, and Completions.

 Note: Thanks to a lot of feedback from you, the IRB has unlocked the IRR form to enable tracked changes. If you are making revisions to your IRR, be sure to enable tracked changes in the review ribbon in Microsoft Word.

 Templates

Directions: There are instructions to aid the investigator on each of the templates. These instructions must be removed from the final version of the document prior to submission to the IRB.

Templates Descriptions
Consent Document This template is used to obtain the legally effective informed consent of individuals before involving them in research. Prior to submitting to the IRB, delete all embedded directions to the researcher or it will be returned as incomplete.
Assent Document This template is used to gain a child's affirmative agreement to participate in research. Prior to submitting to the IRB, delete all embedded directions to the researcher or it will be returned as incomplete.
Parental Permission  This template is used to gain a parent's permission for a child to participate in research. Prior to submitting to the IRB, delete all embedded directions to the researcher or it will be returned as incomplete.
Exemption Reviewer Checklist This template is used by the IRB Administrator  to determine if your protocol qualifies as exempt research.
Reviewer Checklist This template is used by the Board members when reviewing a protocol.
Recruitment Flyer: Word Document or PDF This template is used as a guideline for what should be included in a recruitment flyer.

 

 Waivers

Waivers Descriptions
Waiver of Written Documentation of Informed Consent The purpose of this form is to provide support for IRB members when reviewing research involving the waiver of written documentation of informed consent. This form must be used to request a waiver of written documentation of informed consent based on federal regulation 45 CFR 46.117 [c].
Waiver of Informed Consent The purpose of this form is to provide support for IRB members when reviewing research involving the waiver of informed consent. This form must be used to request a waiver of informed consent based on federal regulation 45 CFR 46.116 [d].

 

 Thank you for using our new forms and please remember to complete this brief survey to give us some feedback on the new forms.

 

Research Support Services
Administration Building 315
Memphis, TN 38152
Phone: 901-678-2533
Fax: 901-678-2199

Human Subjects Protection Program
Institutional Review Board
Administration Building 317
Memphis, TN 38152
Phone: 901-678-2705
Fax: 901-678-2199

Text Only | Print | Got a Question? Ask TOM | Contact Us | Memphis, TN 38152 | 901/678-2000 | Copyright 2013 University of Memphis | Important Notice | Last Updated: 
Research Support Services | Administration Building 315 | Memphis, TN 38152 | Phone: 901-678-2533 | Fax: 901-678-2199
Last Updated: 9/12/13