50thAnniversary

Forms, Templates & Samples

All research projects involving interactions with human subjects conducted for class-related projects, internships, culminating projects, theses, and dissertations must be submitted to the IRB for review and approval. Failure to submit such applications may result in the loss of all collected data.

Theoretical, creative, and scholarly inquiry research projects conducted for pilot studies, culminating projects, theses, and dissertations must also be submitted to the IRB for review for exemption. Examples include literature reviews, contextual essays, novels, performances, and art pieces. IRB Notification for Theoretical / Creative Research Projects should be submitted to the IRB for review and approval as being eligible for exemption. A summary of the proposed study that includes a description of the data sourse(s) and the data collection methodology is required. Exemption approvals will be sent via e-mail. Research projects deemed ineligible for such exemption must be submitted for Expedited or Full IRB review, using the IRB Application and Research Proposal form.

The following IRB forms may also be downloaded from the UI&U Forms Directory:

IRB Application and Research-Related Forms – See IRB Handbook Chapters 6 and 7.

  • Submit all forms to your faculty advisor for review and approval before submitting them to the IRB for review and approval. Your advisor’s approval is needed before the IRB can approve your study.
  • Undergraduate faculty advisors submit IRB applications and serve as faculty principal investigators (PIs) for their undergraduate students.
  • PsyD faculty advisors serve as faculty PIs for their students engaged in human subjects research.
  • Graduate faculty advisors supervise their student’s human subjects research projects and are important sources of information when conducting research.

Forms

IRB Application and Research Proposal

Requirements: Form is required for human subjects research projects, including class projects in which data/ results will be used for a dissertation, thesis, final project, or other purpose. Instructions for preparing the application and research proposal are available in pdf through the link in the left column.

Description: Use when interactions with human subjects involve minimal risk (expedited review) or more than minimal risk to subjects (full review).Use with survey, questionnaire, interview, and other data collection methods in which personally identifiable information about subjects is collected, including Internet interactions with humans such as surveys, focus groups, and interviews.

Expedited Review Checklist

Requirements: Use checklist to verify eligibility for expedited review. Submit with the IRB Application and Research Proposal and all study documents. See the Instructions for Preparing the IRB Application and Research Proposal.

Description: Use to describe interactions with human subjects and data collection procedures that involve no more than minimal risk.

Exempt Research Study Checklist – Application

Requirements: Use checklist to verify eligibility for exemption. Submit along with a description of the proposed study, including data collection method(s). Informed consent forms may be required. Attach interview or survey questions used in the study.

Description: Use for human subjects research involving specific types of data, data collection method(s), or human subjects interaction. Humans are involved in some way in exempt research studies.

Notification for Theoretical / Creative Research Projects

Requirements: Submit form and a summary describing the proposed research, including data collection method(s). Form is required for such studies in all degree programs.

Description: Use for theoretical or creative research, including contextual essays and artistic projects, that does not involve interactions of any kind with human subjects.

Modification Request

Requirements: Required when changes of any kind are made to a study that has already been officially approved by the IRB. Changes may not be implemented until IRB approval is obtained.

Description: Modifications, such as study location, participant population, instruments, or consent forms, must be approved before they are implemented after official IRB approval – before the project begins or while in progress.

Progress Report-Renewal Request

Requirements: Request renewal of IRB approval (extention of time). Notify the IRB that data collection has been completed and no more interactions with subjects will occur.

Description: IRB approval must be renewed (extended) when data collection and interactions with subjects are not completed by the expiration date of previous IRB approval – 12 months. Study completion notification: Notify the IRB when all data collection and participant interactions are complete.

Your Rights as a Participant in Research

Requirements: May distribute to participants involved in any research project to inform them of their rights.

Description: A research study handout on Union Institute & University letterhead.

IRB Consent Forms

Comprehensive Informed Consent Form(INSTRUCTIONS for preparing the comprehensive informed consent form)

Requirements: Submit with IRB Application and Research Proposal, Exempt Research Study Checklist – Application, or Expedited IRB Review; include translations for non-English speaking participants. Instructions for preparing the comprehensive informed consent form are available in pdf through the link in the left column.

Description: Use when conducting human subjects research projects eligible for expedited, exempt, and full review.Also use for class projects for which data will also be used in a dissertation, thesis, professional presentations, or journal articles beyond the class environment.

Abbreviated Consent Form

Requirements: Submit with the IRB Application and Research Proposal, a summary of the proposed study, and data collection instruments. Researchers, or a native language speaker, must read the summary to potential participants and give them a copy of the summary. Include a witness statement and signature/ date lines on the form. Witnesses must be proficient in the participants’ language. Click instructions link on the left.

Description: Use when research participants are non-English speakers or are unable to read the consent form. Participants sign the study summary and the consent form.

Template – Consent Statement and Debriefing for Online Study

Requirements: Consent forms are required for online studies involving human subjects. This consent statement should be adapted for the proposed study. The debriefing may be used to thank participants or to include additional information about the study.

Description: Insert this consent statement at the front of surveys, questionnaires, and other instruments created on online survey provider sites or other Web sites. Insert Debriefing after the survey. Using the debriefing is optional.

Class-Related Research Project Forms

Instructor Application for Class-Related Research Project

Requirements: Submit to request approval for assigned class projects involving human subjects — for studies in which the data/ results will or will not be used beyond the class environment in disserations, theses, or other purposes.

Description: May be used for blanket approval for class research projects that involve the same data collection method(s) and no more than minimal risk to participants.

Student Class-Related Research Project Application

Requirements: Submit for class research projects in which the data/ results will NOT be used beyond the class environment. If data/ results WILL be used beyond the class environment, the IRB Application and Research Proposal must be submitted to the IRB for review and approval. Include data collection instrument(s). See also the Instructions for Preparing the IRB Application and Research Proposal. Submit the Comprehensive Information Consent Form also. See the Instructions for Preparing the Comprehensive Consent Form for guidance.

Description: Use to describe purpose of study, what participants will be asked to do, and how data will be collected.

Class Research Project Consent Form

Requirements: Submit for class-related research projects in which the data/ results will NOT be used beyond the class environment in dissertations, theses, other final documents, journal articles, or professional presentations. Include data collection instrument(s).

Description: Use for class projects that involve no more than minimal risk.

Sample Forms and Templates

[Sample] Informed Consent – Parent / Guardian

Requirements: Submit with the IRB Application and Research Proposal. Include appropriate assent form for child(ren), recruitment materials, and data collection instruments. See the Instructions for Preparing the IRB Application and Research Proposal.

Description: Use sample as a guide for preparing a consent form to fit the proposed study.

[Sample] Assent Form – Minor Child

Requirements: Submit with IRB Application and Research Proposal. Include appropriate parent/ guardian form, recruitment materials, and data collection instruments.

Description: Use sample as a guide for preparing an assent form to fit the proposed study and age level of child participants.

[Sample] Information – Consent Letter for Mailed Survey

Requirements: May use this letter and consent form when mailing a survey or questionnaire to potential participants. Submit with IRB Application and Research Proposal and data collection instrument.

Description: Combination recruitment letter and informed consent statement. Use to invite participants to complete and return an enclosed survey or questionnaire. Letter includes all necessary consent information.

Template – Confidentiality Agreement – Transcriptionist

Requirements: Use to ensure confidentiality protection of audiotapes, transcripts, and computer files when the transcriber is not the researcher. Use is optional.

Description: Form may be used to establish a legal confidentiality agreement with the transcriber of interview and/or focus group audiotapes to prevent any unauthorized use of any part of the tapes and/or transcripts.

Template – Videotaping Release

Requirements: Use to describe to participants how videotapes of their interviews or other activities will be used in the study and after the study is completed.

Description: May use this form to establish legal ownership of the videotape and of the copyright of any videotapes or other publications resulting from participation in a research study.