Office of Research Assurances

Institutional Review Board (IRB)

Human Subject Forms & Templates


Forms
Exemption Determination Application   DOC (revised Oct 16, 2015)
Non-Exempt Application   DOC (revised Oct 16, 2015)
Request for Amendment   DOC  
Continuing Review Form   DOC  
Closeout Report Form   DOC  
Adverse Event Form PDF RTF  
Reporting Deviations   DOC  
Templates
Guidance on Writing Consent Forms PDF    
Consent Template   RTF  
Assent Template (Ages 7-10)   RTF  
Assent Template (Ages 11-14)   RTF  
Assent Template (Ages 15-17)   RTF  
Parent Permission Form Template   RTF  
Addendums
Addendum 1 Expedited Categories and Determination   DOC  
Addendum 2 Research with Children   DOC  
Addendum 3 Research with Prisoners   DOC  
Addendum 3A Research with Prisoners   DOC  
Addendum 4 Alteration of Informed Consent Process   DOC  
Addendum 5 Waiver of Documentation of Informed Consent Process   DOC  
Addendum 6 Waiver of Informed Consent Process   DOC  
Addendum 7 HIPAA Authorization Form & Appendix A   DOC  
Addendum 8 Investigational Drugs, Other Drugs, & Devices   DOC  
Addendum 9 Blood, Tissue, Bodily Fluids, or Other Biological Specimens   DOC  
Addendum 10 Confidentiality Agreement   DOC  
Guidance
Application Instructions and Guidance PDF    
Adult Informed Consent Checklist PDF    
Parental Permission & Child Assent Checklist PDF    
Application Review Checklist PDF    
Institutional Review Board, P.O. Box 643005 Albrook 205, Washington State University, Pullman WA 99164-3005
Human Subjects Protection Manager: Malathi Jandhyala, irb@wsu.edu, Phone: 509-335-3668, Fax: 509-335-6410
Director, Office of Research Assurances: Michael Kluzik, Phone: 509-335-9553