UMMC Investigator Request to Cede IRB Review
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Name* |
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Email address* |
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UMMC Principle Investigator's name and email address (if different) |
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UMMC department |
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Scope of UMMC's engagement (select all that apply)* |
If other:
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Attach study protocol |
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Name of the external IRB (institution) upon which you are asking to rely* |
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Title of the study* |
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A lay description of the study and study aims* |
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Funding source or sponsor of the study* |
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Method of agreeing to reliance* |
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Please work with the external IRB's administrative staff to answer the
following questions:
Please work with the external IRB's administrative staff to answer the following questions:
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External IRB's Federalwide Assurance Number* |
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Expiration date* |
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External IRB point of contact information* |
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Confirmation that the external IRB is in good standing with OHRP and FDA (no recent warning letters, no open investigations)* |
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Confirmation that the external IRB is located within the U.S.* |
STOP HERE - Please contact the Human Research Office
at umcirb@umc.edu before proceeding further.
If you selected No to the question above, STOP HERE - Please contact the Human Research Office at umcirb@umc.edu before proceeding further.
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Confirmation that the external IRB has applicable policies and procedures in place* |
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Whether the IRB has elected to extend its FWA to all research* |
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Confirmation that the external IRB is AAHRPP-accredited* |
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Human Research Office
Human Research Office
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Please attach study Informed Consent Form template (if applicable) so that UMMC?s institutional language requirements can be reviewed or inserted by the Human Research Office* |
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Please note: once permission to cede IRB review of the study has been granted, the study still needs to be submitted in Cayuse and receive a local administrative review prior to initiating conduct of the study.
Please note: once permission to cede IRB review of the study has been granted, the study still needs to be submitted in Cayuse and receive a local administrative review prior to initiating conduct of the study.
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For any questions regarding this form or IRB reliance, please reach out to the Human Research Office
at umcirb@umc.edu.
For any questions regarding this form or IRB reliance, please reach out to the Human Research Office at umcirb@umc.edu .
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