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Institutional Review Board (IRB) Forms
The links below require Adobe® Acrobat Reader or Microsoft® Word to view. Problems with PDFs on Mac?
IRB Toolkit
The IRB Toolkit is a user-friendly resource for new and existing employees. The Toolkit is formatted for visual ease and guidance through the IRB submission processes. The Toolkit uses a Flow Chart format that highlights key information.
New Study Forms
- Request for New Protocol Review
- Recruitment and Consent/Assent Information Form
- Expedited Review Guidance
- Unaffiliated Investigator Agreement
Continuing Review Forms
- Application for Continuing Review of Protocols
- Continuing Review Form for Exempt Studies
- Expedited Review Guidance
Amendment Forms
Informed Consent Documents
The informed consent process gives potential subjects a description of the study that is clear and complete enough for the individual to judge whether she or he wants to participate. The standard expectation is that all subjects will sign a document containing all the elements of informed consent. Fox Chase uses common consent form templates, listed below:
- Informed Consent Document Template-Cancer Prevention and Control
- Informed Consent Document Template-Clinical
- Waivers
- Non-English Consent Form Short Version
- Translation Documentation Form
- Readability Guidelines for Consent Forms
- Chemotherapy Information for FDA Approved Drugs (Risks/Side Effects)
HIPAA Forms
For more information about HIPAA, please click here.
- HIPAA Authorization-Cancer Prevention and Control
- HIPAA Authorization-Clinical
- HIPAA Revocation of Authorization for Disclosure of Protected Health Information
- Waivers
Patient Safety Issue Forms
- Adverse Event Form-Cancer Prevention and Control
- Serious Adverse Event (SAE) Reporting Form (Adverse Event Form-Clinical)
- Protocol Deviation/Violation Form
- Unanticipated Problems Involving Risks
Other
- Change in Study Status Form (Termination)
- Conflict of Interest Form
- Request for IRB Study Status Information
For more information, please call the IRB office at 215-214-3754