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General Information |
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For
best performance, right click form/document link and save to
your PC before using.
*No.
of copies Needed
*IRB Calendar 2009
IRB Calendar 2010 *IRB
Statistics
2005
Last 12 months
*IRB Members Roster
2004
2005
2006
2006-late
2007
2009
2010
*How to write a proposal (1201.1 Handbook)
*ORD
Mandate for FHPP Support Fee of $1200
* Check
List for Human Studies |
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FORMS |
INSTRUCTIONS |
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01 Cover
Page,
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02 Pages 1 and 2 ,
Page3 |
Funding source codes & Administrative
Codes
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03
Letter of Support Lab
Service (if applicable) Letter
of Support Imaging (if
applicable)
Letter of
Pharmacy Support
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Instructions
for request to Pharmacy |
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05
Application for review of research
or
Application
for review animals or science only initial
or
R&D Application
for Continuing Review |
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06
Human
Research Determination form
Consent Form 10-1086
with Surrogate
Consent
Form 10-1086
Consent
Log
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Consent SOP
Consent Form
Guidance
Readability
Tips
DMC procedure
for use
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07 Scan Consent
Request Form
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08
HIPAA
Waiver request
PHI Disclosure
Report
Study Monitor Visit
Report Form |
HIPAA
mandate
PHI Disclosure
Report Memo
Study Monitor
Reporting Directive
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09
Drug Information Form 10-9012
Investigation
Device Supplemental Application |
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10 IT Security The
following Security Forms are for use as appropriate:
Application Take Data from VA form
Data transfer Agreement to another VA
Data Transfer Agreement non-VA
Devices with PHI Inventory
ECAR (Electronic
Computer Access Request):
https://ecar.v03.med.va.gov/do/main/logon
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SECURITY
ECAR is for requests for
authorization to transport/utilize sensitive information outside
VANJHCS protected environment
and
requests for IRM provided equipment
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11 Investigator's
Responsibility Agreement |
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12
Investigator's Personal Financial
Disclosure |
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13 Safety Form
14 Safety
Committee Annual Review Form 15
Safety
Training Form |
MCMs
Used on Safety Form
Research
Safety Laboratory Training (large file 8 mb, right click
and save to your PC before viewing for best performance) |
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Additional
Initial Application Forms |
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Non-Vet
10-10EZ Form for Registration (2005)
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Procedures
for Non-Vets
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Off Site Research
Application Form
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Instructions
for Off Site Application
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WOC
Orientation Checklist
WOC
Certification
VANJHCS Scope of
Practice for Research Staff
+ CV + copy of licenses
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Credentialed Employees are exempt
from Scope of Practice |
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CRADA-CT Phase I and II
CRADA-CT Phase
III,IV
CRADA-Material
Transfer
CRADA-Investigator
Initiated
CRADA-Science
Only
CRADA-Devices |
CRADA Guidelines |
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VANJ Health
Care Animal Studies Forms
VA ACORP Forms (must use after Jan 1, 2005) |
Required Training
VA Handbook Animal
Use |
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DHHS forms |
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Post Approval Activity Forms
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Amendment Request
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IRB
Continuing Study or Closure Form
Safety
Continuing Study Form
IRB
Continuing Scope of Practice Form |
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Event/Problem Report Form |
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IRB
and R&D Reviewer Tools |
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IRB
Meeting Accession Regulatory Check List
IRB Emergency
Use Reviewer Form
IRB
Meeting Regulatory Check List
IRB Device
Review Form
IRB Initial Review Form
IRB
Finance Disclosure of PI Reviewers Form
IRB Continuing Review Form
IRB DMC Review Form
IRB Amendment
Reviewer Form
IRB / R&D Members Conflict of Interest Form
IRB Review for
Noncompliance Form IRB
Ad Hoc Reviewer Conflict of Interest Disclosure
Post
Privacy Review form |
IRB Reviewer's Reference Guide |
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VBRI |
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Visit http://www.vbri.org/forms.htm
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