Human Research Protection Program

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Forms and Templates

Other non-IRB forms

 



Research Not Involving Human Subjects

Proposal Application for Research Activity Not Involving Human Subjects (doc)

View the application for proposals for research activity that does not involve human subjects for submission to the MCW/FH IRB

NCI CIRB

Amendment Request for CIRB Facilitated Review

 Use this form to request MCW/FH Facilitated Review of an NCI CIRB Protocol Amendment.

CPR Request for CIRB Facilitated Review – Long-Term Follow-up or Data Analysis

Use this form to request MCW/FH Facilitated Review of an NCI CIRB Protocol Continuing Progress Report (CPR) for studies that are in long-term follow-up or data analysis phases.

CPR Request for CIRB Facilitated Review – Active Studies

Use this form to request MCW/FH Facilitated Review of an NCI CIRB Protocol Continuing Progress Report (CPR) for studies that continue to enroll subjects and/or in which participants remain active in study procedures.

CIRB MCW/FH IRB Continuing Progress Report (CPR) Form

Use this form to submit a Continuing Progress Report (CPR) to the MCW/FH IRB for Facilitated Review of NCI CIRB Studies.

Request for MCW Oversight

Use this form to request a change in oversight of an NCI CIRB study to the MCW/FH IRB.

Protected Health Information Authorization forms

Authorization to Use or Disclose PHI in Research

Obtain direct authorization to use or disclose PHI for screening purposes

Authorization to Use or Disclose PHI in Research

Obtain direct authorization to use or disclose PHI for screening purposes

Request for Waiver of Authorization for PHI

Obtain access to PHI for research on decedents

Other Documents

IND Exemption Form for Investigators

Use for studies that meet ALL three criteria specified on the form

Banking Protocol Procedures Template

Questions/prompts used to describe the procedures that will be used to manage the bank consistent with the “MCW/Froedtert IRB Policy on Banking”, dated Nov. 12, 2008

De-identified Data Agreement

Model letter to include in IRB submission

eBridge SmartForm PDFs

Electronic copies of the eBridge SmartForms

These documents are for review purposes only, and will not be accepted in place of an electronic submission. 

 

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Page Updated 11/20/2009