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

      
Friday, Sep 03, 2010
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  IRB
  CCBHS
  627 S. Wood Street
  Chicago, IL 60612
  Phone: 312-864-0716
  Fax: 312-864-9210
 

 
 
DOWNLOAD  CCBHS APPROVAL FORMS
 
 
See also:    Forms Checklist     Guide to Forms on Disk

These forms are used to apply for: 
  • IRB approval for human research
  • Administrative approval to make a grant application 
  • Animal Committee approval for vertebrate animal research
All forms are available in Wordperfect (v. 6, 7, 8) and Microsoft Word for Windows 

Forms are grouped according to their function, as shown in the table below.  To find out which forms are necessary for which purpose, see the Approval Forms Checklist.

You can save any of these forms on your computer by pressing SHIFT and CLICK at the same time on the file extension (WPD or DOC) for the version you want.  The "Save" menu will appear, and you can then save the file with any name and in any directory you specify. 

 

CLICK ON: 
DOC (Microsoft Word) 
 FORMS    FILE
 NAME 
 MICROSOFT
WORD 
D-I    Administrative Approval Forms 

D-I.a  Project Description
D-I.b  Institutional Commitment of Resources
D-I.c  Resource Approvals
D-I.d  Pathology Resources
D-I.e  Financial Summary
D-I.f  Administrative Agent Approval
D-I.g  Finance Office approval
D-I.h  Institutional approval

D-I D-I
D-II  Additional Administrative Forms to be Used as Needed

D-II.a  Pharmacy Commitment Form
D-II.b  Laboratory Commitment Form
D-II.c  Research Safety Form
D-II.d  Financial Interest Statement
 

D-II D-II
D-III   Application for Scientific Committee (IRB) Approval

D-III.a  Investigators' Acknowledgment
D-III.b  Abstract of Research Proposal
D-III.c  Description of Subjects
D-III.d  Request for Waiver of Consent or Waiver of documentation
D-III.e  Request for Expedited Review
D-III.f  Request for Exemption from Review

 
D-III D-III

 
 
 
 
 
D-III-f

D-IV Scientific Committee Report Forms

D-IV (PWS).  Pregnant Women, Neonates
D-IV.a.  Research Study Progress Report Form
D-IV.b.  Adverse Event Report Form
D-IV.c.  Amendment Cover sheet
D-IV WS DS.  Wards of state and detainees
 

 

D-IV (PWS).
D-IV.a.
D-IV.b.
D-IV.c.
D-IV WS DS.

   

D-IV (PWS)
D-IV.a.
D-IV.b.
D-IV.c.
D-IV WS DS

D-V  Sample Consent Forms

D-V     Instructions
D-V.a  Sample Consent Form for Competent Adults
D-V.b  Sample Consent Form for Minors
D-V.c  Sample Consent Form for Persons Lacking Decision Making Capacity
D-V.d. Suggested Language
 

D-V D-V
 
 
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