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The Office of

Human Research Ethics

General Information

For Investigators

For Research Participants and the Public

IRB-Related Forms

There are a variety of forms available, and their use depends on the nature of the study and where it is in its life cycle. People new to the IRB process might benefit from the Guide to the IRB Process.

See Submission Instructions for number of copies and where to send the application. See also meeting deadlines and schedules, important for studies that must be reviewed by the convened IRB ("full board" studies).

Forms may change without notice, and old forms will not be accepted after some period of time. You are strongly advised to go to this web page and download a current form each time you need to submit to the IRB.

Most forms are in Microsoft Word; some are Adobe Acrobat PDF.

Initial Application

Forms
Application for IRB Approval of Human Subjects Research
(updated 25-June-2009)
Addendum for Multi-Site Studies Where UNC-CH is the Lead Coordinating Center
Determination Whether Research or Similar Activities Require IRB Approval
(see instructions on form for when to use this)
(updated 22-May-2009)

Consent

Templates for Standard Consent Documents
(English documents revised 2-Oct-2007; Spanish, 7-Sep-2005, unless otherwise indicated)
Biomedical
Social Behavioral
Consent to Participate in a Research Study
Adult Subjects
English:
(updated 22-May-2009)
Spanish:
English:
(updated 22-May-2009)
Spanish:
Parental Permission for a Minor Child to Participate in a Research Study
English:
(updated 22-May-2009)
Spanish:
English:
(updated 22-May-2009)
Spanish:
Assent to Participate in a Research Study
Adolescent Subjects (15-17 yrs)
English:
(updated 22-May-2009)
Spanish:
English:
(updated 22-May-2009)
Spanish:
Assent to Participate in a Research Study
Minor Subjects (7-14 yrs--use for Biomed and Soc/Beh)

Consent for Stored Specimens, Identified
Consent for Stored Specimens, Unidentified
(instructions for applications that include use of specimens)

English:
English:
(updated 24-Jun-2009)
Addendum to provide additional information to subject after original consent
English:
(8-Sep-2008)
SSN Collection Forms
1. Use with subject to obtain permission to collect Social Security Number for payment
2. Use with subject to obtain permission to collect Social Security Number to use as an identifier
(see SSN guidance for details)
English:
(updated 28-Sep-2007)
Spanish:
(updated 16-Jun-2008)

English:
(updated 28-Sep-2007)
HIPAA Addendum to Consent Form
HIPAA Authorization Template
English:
(updated 18-Mar-2009)
Spanish:
(updated 16-Sep-2005)
Alternatives to Full Consent Forms; Examples
Short Consent Form (for a single subject who may be illiterate, blind, or otherwise unable to read the consent form — used when full consent form has to be read or translated for subject; updated 22-May-2009)
Telephone Consent Script (example)
Postal or Email Letter for Anonymous Questionnaire (example)
Information or Fact Sheet (example)
Focus Group (example)

Submissions After Initial Approval: Renewal, Termination, Modification, Adverse Events

Important note for studies that were approved before March 15, 2005: If you used one of the initial application forms current before the formation of OHRE, these are usually grandfathered for renewals and modifications. However, if the IRB finds that the information on the old initial application form is inadequate, you may be requested to update to the new initial application form. Use the new (and brief) submission sheets below for modifications or renewals, but you may attach the existing approved description of the study (IRB application) and consent forms. Application and consent forms may be reformatted if the investigator prefers to use the new templates, but this is not required for previously approved studies. See the IRB Changes FAQ for additional information.

Form
Request for Renewal of IRB Approval or Study Closure
(updated 26-Aug-2009)
Modification of Approved Human Subjects Research (updated 22-May-2009)
Effective June 1, 2009, Unanticipated Problems and Adverse Events must be reported online. Click here for instructions, training, and access to the web portal.  

Other Forms

HIPAA-Related Forms for Access to Records at UNC-CH (not OHRE forms)
UNC HCS Form HD974: Request for Access to PHI or Aggregate Data for Research Purposes (UNC Hospitals medical records) (updated 7-Feb-2006)
UNC School of Dentistry Request for Access to Protected Health Information (PHI) for Research Purposes
UNC School of Dentistry Guidelines for Release of Protected Health Information (PHI) for Research Purposes
Miscellaneous
Responsibilities of Staff in Human Subjects Research
Statement of Compliance
Report of Emergency Use of a Test Article to the IRB (updated 01-Apr-2009)

Other Approvals that Might Be Required

Other UNC-CH Guidance and Forms (primarily links to other web sites)
CTRC Guidance and Forms
Environment, Health and Safety
Oncology Protocol Review Committee
Investigational Drug Service (IDS)
Conflict of Interest Policy  
Request to Conduct Research with UNC Hospitals Staff (coming soon)