The University of Arizona

Forms Index

Report Misconduct

Ethics Hotline

HSPP Contacts

VPR-IRB@email.arizona.edu

Mariette Marsh, Director
(520) 626-7575

Andi Encinas, IRB Manager
(520) 626-8630

Liz Baldry, IRB Associate
(520) 626-0256

Mason Burchfield, IRB Associate
(520) 626-0433

Gina Fimbres, IRB Associate
(520) 626-0026

Christine Melton-Lopez, IRB Coordinator
(520) 626-5859

Courtney Olson, IRB Associate
(520) 626-1744

Darlene Villicana, IRB Associate
(520) 626-6282

Street Address
1618 E. Helen Street
Tucson, AZ 85721

Mailing Address
POB 210409
Tucson, AZ 85721


HOW ARE WE DOING?

Customer Service Survey


 

Applications for Review

Determination of Human Research (Word)

F200: Application for Human Research (Word)

F203: Application for Retrospective Review of Data or Specimens (Word)

F204: Application for Ceded IRB Oversight (Word)

F299: Request for University of Arizona Human Research Site Authorization (Word

Appendices

Appendix A: Children (Word)

Appendix B: Drugs and Devices (Word, PDF)

Appendix C: Multi-Site Research (Word)

Appendix D: Pregnant Women and Neonates (Word)

Appendix E: Prisoners (Word)

Appendix F: Waivers of Consent and Signatures or Alterations (Word)

Appendix G: Exceptions from Informed Consent (EFIC) (Word)

Appendix H: Native American or Indigenous Research (Word)

Renewals

F212: Renewal Progress Report (Word)

F212B: Concluding/Admin Resolution (Word)

Amendments and Reportables

F109: Amendment of Key Personnel (Word)

F213: Amending Approved Human Research (Word)

F215: Minor Amendment of Approved Human Research (Word)

F216: Notify IRB (Word)

F224: Reportable New Information that is Potentially Problematic (Word)

Additional Forms

F107: Verification of Human Subjects Training (VOTF) (Word)

External Site Authorization (Word)

Institutional Certification for NIH Genomic Data Sharing (Word)

Consent Templates

T502a: Informed Consent Form Template (Word)

T503a: University of Arizona- Banner Health Consent Form Template (Word)

T502b: Addendum Template (Word)

T504a: PHI Authorization Form Template (Word)

C100: Elements of Consent (Word)

C101: Protected Health Information (PHI) Guidelines (Word)

Multi-Site Research   

Appendix C: Multi-Site Research (Word)

F213b: Amending Research for a Multi-Site (Word

F107b: Multi-Site List of Personnel (Word

F212c: Multi-Site Renewal Progress Report (Word

Individual Investigator Agreement (Word)

IRB Reliance Agreement – Ceding Review (Word)

IRB Reliance Agreement – UA Reviewing IRB (Word)

Humanitarian Use Devices

F221: Continuing Review Progress Report for Humanitarian Use Devise (HUD) (Word)

F222: Amendment of Approved Humanitarian Use Device (HUD) (Word)

C104: HUD Reponsibilities Checklist (Word)