Forms

Applications

Reminder: Before you begin filling out the application, be sure to save it to either your desktop or an easily accessible location on your device.

• Application for Research Using Human Subjects (Word Document)
• Verification of Exempt Research (Word Document)

Sample Informed Consent Forms

• Adult Informed Consent form (RTF)
• Child Written Consent form (RTF)
• Child-Verbal Informed Consent form form
• ProMedica Adult Informed Consent form (Word)
  This informed consent form is to be used for projects that are conducted at any ProMedica facility.
• Parent/Guardian Permission letter (RTF)
• Adult Information letter (Word)

Waivers – Informed Consent

• Request to Waive Signature (PDF)
• Request to Change Requirements of Informed Consent (PDF)

Permission Forms

The following forms require a hard signature. This means that the forms must be signed, scanned and submitted along with the IRB Application:

• Agency Permission Form (Word Document)
  This form shows that permission has been granted to the investigator for access to the necessary data/resources/employees to complete the study.

Amendments and Continuing Reviews

• Amendment Request (Word Document)
• Continuing Review (Word Document)

Completion of Project

• Project Closure Form (Word Document)