IRB, Office of Research Development COOK COUNTY BUREAU OF HEALTH SERVICES
Office of Research Development

      
Friday, Nov 20, 2009
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  627 S. Wood Street
  Chicago, IL 60612
  Phone: 312-864-0716
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Guidebook 
SECTION B: FORMS CHECKLIST
 
 
Applications for Funding
New Research Projects
      Human Research
      Animal Research
All Research (Financial Interest)
Consent Forms
Continuing Projects
See also:
Downloading Forms    Bureau Approval Forms
Who Signs What     FAQ: Forms
 
APPLICATIONS FOR FUNDING Forms/Documents Required: Found in Section
IF   This is an application for external funding (grant, contract, cooperative agreement, gift or donation)
 
Section D-I is required for all applications for external funding, including non-research projects, research projects that are exempted from IRB review, and animal research projects.
Administrative Approval Form

Copy of grant application

Copy of project budget

D-I
IF   This project will use the resources of the following for more than routine care: 

Pharmacy Services

Laboratories

Pharmacy Commitment Form

Laboratory Commitment Form

D-II.a

D-II.b

IF       Biohazardous materials will be brought to the facility specifically for this project;

OR

Research Biosafety Form 
 

 

 
Radioactive materials will be used for research purposes apart from normal clinical care;

OR

This project will employ recombinant DNA

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NEW RESEARCH PROJECTS
Human Research Forms/Documents Required: Section
IF        This project will require either a full or expedited IRB review (See Section C.11)

OR 

Administrative Approval Form

Scientific Committee (IRB) Approval Form

Complete Protocol

Consent Forms to be used, reproduced on letterhead

D-I

D-III

D-V

IF     This project qualifies for an exemption from IRB review (See Section C.16) Request for Exemption from Review  D-III.f

Animal Research
IF       This is a research or training project using vertebrate animal subjects Animal Committee Forms 

Research Protocol

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All Research

IF        You have a significant financial interest in this research project (See Section C.4)
 

Financial Interest Statement D-II.d

 

CONSENT FORMS
 

You may rewrite, reformat or edit these samples as long as the document includes all required elements of informed consent (See Section C.24). Consent forms must be reproduced on institutional letterhead

 
Sample Form to Consult Section
IF  Your study will employ participants over age eighteen Basic Consent to Research D-V.a
IF   Your study will employ participants under the age of 18 (See Section C.29) Permission & Assent for a Minor to Participate in Research D-V.b
IF   Your study will employ persons lacking decision making capacity (See Sections C.30 & C.32) Permission for a  Person Lacking Decision Making Capacity to
Participate in Research 
D-V.c

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CONTINUING PROJECTS
For Human Research Projects: Forms/ Documents Required Section
IF       Your protocol is due to be renewed 
(See Section C.53)
Progress Report Form D- IV.a
IF   You must report an adverse event  (See Section C.55 ) Adverse Event Report Form

A letter with this information is acceptable in lieu of the form

D- IV.b
IF       You wish to request approval for a revision to your protocol or consent form A letter describing the changes and a copy of the new consent form or protocol, if any  

For Animal Research Projects:
IF      You wish to request approval for a revision to your protocol A letter describing the changes   
IF      Your protocol is due to be renewed Animal Committee Annual Report Form 

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