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Main Campus Forms

If you are a health sciences or biomedical researcher, please use the templates on the HIPAA page.

All IRB Applications must be submitted using the ERICA System. Templates that can be attached with your ERICA application are listed below.

Who is in the Covered Entity?

Forms	Version Date
Advertisement Guidelines	07.23.2008
Assent Template	12.19.2006
Case Report Using Existing Data Author Worksheet	06.01.2007
Consent Template	03.07.2007
Consent Template with HIPAA Authorization	03.07.2007
HIPAA Assurance Letter Template	12.28.2007
Information for Accounting of Disclosures	12.28.2007
IRB Authorization Agreement (IAA)	07.21.2008
Parental Permission Template	03.07.2007
Questionnaire Cover Letter - Instructions for Use
Questionnaire Cover Letter Letter Template	08.28.2007
Research Compliance Agreement - Individual Investigator	07.21.2008
Research Compliance Agreement - Institution	07.21.2008
Short Form Consent - Instructions for Use	05.22.2007
Short Form Consent Template (English)	04.27.2007
Short Form Consent Template (Russian)	11.14.2008
Short Form Consent Template (Spanish)	04.27.2007
Translation Certificate - Short Form (Russian)	11.14.2008
Translation Certificate - Short Form (Spanish)	02.13.2008
Study Summary Template	12.19.2006
Translation Certification Letter