Download Health & Biological/Medical Application Form
All forms are in Microsoft Word Format.
 IRB Health & Biological/Medical Application Form version 5.1
updated: 08/09
-
This form must not be handwritten.
-
Fill out all of the questions on this form completely (If there are questions about using the text form fields or checkboxes with this form, please contact the HRPP office 612-626-5654 or irb@umn.edu).
-
Make sure to include the e-mail address and UMN employee/student ID numbers of the PI, Co-investigators and all other personnel.
-
Fill out and attach the appropriate appendices required by responses in this application.
-
Attach supporting documentation: consent form(s), assent form(s), protocol, survey instruments, interview schedules, solicitation letters, advertisements, letters of permission, etc.
-
Complete the checklist that accompanies this form to assure all requirements for submission are completed so that review is not delayed.
-
Submit this application and appendices along with the supporting documentation to the Research Subjects’ Protection Programs Office (HRPP).
- Additional Study Personnel - updated 09/09
If you need to included additional personnel, please use this page and attach it to the application.
- Appendix A - updated 09/08
Research Funding
- Appendix B -under development
Research Involving Pregnant Women/Fetuses/IVF
- Appendix C
Prisoners As Subjects
- Appendix E - updated 05/09
Drugs and/or Biological Products
- Appendix F - updated 05/09
Use of Devices in Research
- Appendix H
Use of Protected Health Information (HIPAA)
- Appendix I - updated 09/09
Targeting/Inclusion of Vulnerable Populations
- Appendix J
Student as PI Worksheet
- Appendix K
International Research
|
|
Download Instructions:
- Right-click on the links above and select "Save Target as..." or "Save Link Target as..."
- A dialog box will appear and you will be prompted to save the file to your computer. Choose a location to save the file.
- Open the file from your computer using Microsoft Word or another compatible word processing program and complete the application form.
Need help with the application process? see Applying for review
Submission Instructions
If applying for Full Committee Review, submit:
-
The original application form and appendices, consent and assent forms;
- 12 copies of these forms;
- 1 copy of the protocol and all other materials.
Or, if requesting expedited review, submit:
- The original application form and appendices, consent and assent forms;
- 1 copy of these forms.
Mail or deliver to:
Human Research Protection Program
MMC 820
420 Delaware St. SE
Minneapolis, MN 55455-0392
Or on campus:
Human Research Protection Program
MMC 820
Minneapolis Campus
|
