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CAMC/WVU INSTITUTIONAL REVIEW BOARD AND INSTITUTIONAL SCIENTIFIC REVIEW BOARD

Document/Form Title Revised Date Fill In (Microsoft Word) Print Only
New Study Application 02/05/08
Word Form
Emergency Use Packet 8/20/04
Word Form
Continuing Review Packet 8/20/04
Word Form
Important Reminders and Changes about Consent Form Format MEMO- dated 10/03 8/20/04  
Template for Patient Enrollment in Research Projects other than Clinical Trials or Sponsored Research
*Note: If the patient is enrolled in a research study but not a clinical trial or other sponsored research with billing components, the 7412 template is to be used. The 7412 form can be used for patients enrolled as inpatients and a copy of it can be placed on the chart (which investigators like to do). It should not trigger the process outlined below like form 7411 does.
11/01/06
Word Form
Drug Data Form
07/27/07
Word Form
PDF document
Form Preparation
07/27/07
Word Form
PDF document
Labratory Data and Pathology Form
07/27/07
Word Form
PDF document
New Technologies Form
07/27/07
Word Form
PDF document
Nursing Participation Form
07/27/07
Word Form
PDF document

Revision Modification Amendment Form

  07/27/07

Word Form

PDF document

Submission of Information Form
07/27/07
Word Form
PDF document

HIPAA forms
HIPAA De-Identification Form
08/10/07
Word Form
PDF document
HIPAA Authorization (2nd person)
08/10/07
Word Form
PDF document
HIPAA Waiver of Authorization
  08/10/07

 

These forms are in pdf format, so they cannot be filled in. Please print them and fill them out as you would a packet from the IRB office. All forms/packets from the IRB office are now available here.
NOTE: W e will be updating some of these documents.  However, these are the most up to date.

All other forms located below


Mandatory Training
Once you complete the online tutorial, print the certificate and submit to Research and Grants Administration.
Your protocol will not be reviewed otherwise.
CITI Log On Instructions




RESEARCH DEADLINES AND MEETING DATES
 download meeting dates and deadlines in pdf document

Note:  Full Board and Expedited applications are due the first working day of the month.  Exempt studies may be submitted any time during the month. Exempt studies will be administratively reviewed and approved within a two-week period 

Investigator Initiated Research Studies:

If your study is investigator-initiated, and full-board or expedited, your application is required to receive institutional scientific review by the Institutional Scientific Review Board (ISRB) prior to review by the IRB.  If your study is a quality improvement project, please call our office at 388-9970 before submitting your application.

Instructions for number of copies of applications to submit to Research Review Office:

Please submit your original and 2 or 17 copies (depending on whether or your study is expedited or full board) of your original application to the Research Review Office in WVU Building, Room 3283, according to the deadlines above for IRB review.

If your study will require ISRB review, please submit your original application and 11 copies of your original application according to the deadlines above. Following ISRB review, the investigator will be notified of necessary revisions. Upon completion of your ISRB review, you will need to submit your revised original and 2 or 17 copies (depending on whether or your study is expedited or full board) to the Research Review Office to begin IRB review.

Contact Information:

Mary Huntley
Director, Research and Grants
Room 3275 (304)-388-9975
Email: mary.huntley@camc.org
ISRB
Carrie Croson

Research Review Specialist
Room 3272 (304)-388-9973
Email: carrie.croson@camc.org

IRB/ISRB Links

The Belmont Report
http://ohrp.osophs.dhhs.gov/humansubjects/guidance/belmont.htm

The Nuremberg Code
http://ohrp.osophs.dhhs.gov/references/nurcode.htm

Declaration of Helsinki
http://www.wma.net/e/policy/17-c_e.html

Federal Wide Assurance Number for IRB
http://ohrp.cit.nih.gov/search/dasurdtl.asp?asuid=FWA00002709&asutyp=X

Provides an excellent sample titled: "How to Write a Human Subjects Application."
http://www.niaid.nih.gov/ncn/grants



GENERAL IRB/ISRB FORM INSTRUCTIONS

1) On all forms you will be on the first field when you open the form
2) Tab between fields
3) Click on the field to go back or to make corrections/changes
4) Click on a box to remove or add an "X" or tab through the boxes
5) Please be certain that the signature at the end of the form appears with the last question on the form- A SIGNATURE SHOULD NOT BE ON A SEPARATE PAGE BY ITSELF. If in the process of completing a form, the signature is the only item on the last page, please enter returns in the second to last question so that the signature is on a page with the final question. A signature should not stand alone on a page
6) If you see something highlighted in yellow, move your cursor over it to receive instructions
7) If you have any technical problems with the forms (not the content),
phone (304)-388-9978

IRB Forms and Policies

Available as fill in forms or in print - Click on Icon for Downloads
Please be advised that these forms and policies may sometimes be updated, but the most current versions should be available on this site.

Please contact 388-9971 or 388-9973 for forms not yet available on line

Document/Form Title

Revised Date

Fill In (Microsoft Word)

Print Only

AE Form - Internal  (SAE-01)

2/22/04

Word Form

PDF document

AE Form - External (SAE-02)

2/22/04

Word Form

PDF document

AE Instructions

2/22/04

PDF document

AE Policy

2/22/04

PDF document

AE Submission Guide

2/22/04

PDF document

AE Tracking Log- SAMPLE

2/22/04

PDF document

AE Tracking Log- Template

2/22/04

Word Form

PDF document

Continuing Review Packet
(Form A & Form B)

2/22/04

Word Form

PDF document

Continuing Review Policy

2/22/04

PDF document

Drug Data Form
07/27/07
Word Form
PDF document

Emergency Use Packet

2/22/04

PDF document

Form Preparation
07/27/07
Word Form
PDF document
Labratory Data and Pathology Form
07/27/07
Word Form
PDF document

Modification/Amendment form - Form B

02/22/04

Word Form

PDF document

New Technologies Form
07/27/07
Word Form
PDF document
Nursing Participation Form
07/27/07
Word Form
PDF document

Revision Modification Amendment Form

  07/27/07

Word Form

PDF document

Revision Log- SAMPLE

   2/22/04

PDF document

Revision Log - Template

2/22/04

Word Form

PDF document

Sponsored Projects Approal App.
04/30/04
Word Form
PDF document
Submission of Information Form
07/27/07
Word Form
PDF document
Sponsored Projects Approal App.
04/30/04
Word Form
PDF document

HIPAA forms
HIPAA De-Identification Form
08/10/07
Word Form
PDF document
HIPAA Authorization (2nd person)
08/10/07
Word Form
PDF document
HIPAA Waiver of Authorization
  08/10/07

 

 

 

 

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