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IRB Forms

To avoid undue delay in the processing of the research protocols, applicants are asked to make sure all of the following components are completed:

  • All responsible individuals involved with the research that are directly involved with human subject participants and/or human subject’s identifiable data must successfully complete the Social/Behavioral Course, Basic Course IRB training.
    • Choose ONLY the Social/Behavioral Course, Basic Course
  • Submit a signed hard copy of the protocol to the Office of Research Integrity, MSC 5738 or stop by Blue Ridge Hall, Third Floor (Room # 342).
    • It must contain signatures of all responsible researchers and the research advisor (if applicable)
  • Submit an electronic copy of the form emailed as an attachment to
    • Protocols must be submitted electronically in MS Word (.doc) format


Reviewers are given five business days to evaluate each completed protocol.


Review Application Form 
Review Application Form Human Research Review Request (Updated 12/16/2015)
  • For more information on the difference between Full Board, Expedited, and Exempt review, please see FAQ's.
  • To place an "X" in a check box, double-click the check box. The "Check Box Form Field Options" window will display. Under "Default value," select "Checked" and then click on "OK."
International Research Form

International Research Form

  • Please complete and submit with the Human Research Review Request Form if conducting research outside of the United States.
Certification Page

Alternative Certification Signature Page

  • Recommended for use when needing to obtain signatures for additional PI's.
Informed Consent Forms
Confidential Research Sample Consent Form
  • Used when:
    • Subject is being interviewed
    • Subject is being recorded (audio/video)
    • Face-to-face interaction between researcher and subject
    • Identifying information is being collected from subject (name, social security number, etc.)
  • There are many circumstances where a researcher may choose to protect a subject's identity by not referring to them by name in their research (i.e., use a pseudonym). This serves to make their responses confidential, but is not the same as conducting an anonymous study. There should be a signature block for the researcher(s) and the participant.
Anonymous Research  Sample Cover Letter
  • Used when:
    • Subject's identity to remain "anonymous" ("Anonymous meaning that the researcher can in NO WAY identify the subjects)
    • No identifying information is being requested
    • A survey/questionnaire is being administered and the researcher will not be present while the surveys/questionnaires are being completed or that the participants will place their completed surveys/questionnaire in an envelope/box to ensure anonymity (Must be stated in the protocol and in the cover letter.)
  • There should be a signature block ONLY for the researcher-- the participant should not sign anything in an anonymous study.
"Web" Confidential

Sample "Web"/"Email" Consent Form

  • Recommended for use with email and Qualtrics for Confidential Research
"Web" Anonymous

Sample "Web"/"Email" Cover Letter

  • Recommended for use when using Qualtrics for anonymous surveys
Verbal/Oral Informed Consent

Sample "Telephone" Survey Consent

  • Telephone interviews require the researcher to obtain verbal consent. The investigator should convey essentially the same information on the phone as on a consent form.
Parental Consent for Participants Ages 17 & Under Parental Consent Form (Updated 08/29/2014)
Assent for Participants Ages 13-17

Youth Assent Form

Youth Assent Form By Line (New 02/13/2015)

Youth Assent Form By Paragraph (New 02/13/2015)

Youth Assent Form By Symbols (PDF) (New 03/31/2015)

Youth Assent Form by Symbols and Paragraph (PDF) (New 03/31/2015)

Assent for Participants Ages 7-12

Child Assent Form

Child Assent Form By Line (New 02/13/2015)

Child Assent Form By Paragraph (New 02/13/2015)

Child Assent Form By Symbols (PDF) (New 03/31/2015)

Child Assent Form by Symbols and Paragraph (PDF) (New 03/31/2015)

Additional Research Forms
Off-Campus Research Site Letter of Permission
Adverse Event/ Unanticipated Problem Adverse Event/ Unanticipated Problem Form
End of Research Close-Out Form (Updated 09/08/2016)
  • This form is used for research that is now complete OR if research was not conducted.
Extension Request

Extension Request Form (Updated 09/08/2016)

  • This form is used to request a continuation of a study beyond the original project end date.
Addendum Request

Addendum Request Form (Updated 09/08/2016)

  • This form is used to request a change to a previously approved protocol.
Evaluation IRB Reviewer Protocol Evaluation Form