Forms and Resources

Download the following research forms to complete and send to Research at Saint Alphonsus. All of the following forms are in a Word or Excell format and must be filled out completely and then can be emailed to Research Integrity.

Research Forms

(updated 05/09/12)

• Initial Protocol Submission of Research Study
• Research Study Reapproval Form
• Request for Amendment
• Request for Expedited Review
• Request for Exemption
• Permanent Study Close-Out
• Determining Quality Improvement
• Final Project Closure
• Financial Disclosure
• HIPPA- Use and Disclosure of Protected Health Information
• Informed Consent/HIPAA Authorization Template
• Checklist for Emergency Use of an Investigational Drug/Device
• Adverse Event Reporting Form
• Grant and Research Project Authorization Form
• Clinical Trial Billing Information Sheet
• Protocol Deviation Reporting Form

Study Submission Guidelines

• CITI
• IRB Meeting Dates
• Informed Consent Checklist (Table Format)
• Protocol Checklist (Table Format)

Additional Resources

• Office of Human Subject Research
• Office of Research Integrity
• Office of Human Research Protections
• FDA
• CITI Program