The University of Arizona

Human Subjects Protection Program Forms

Report Misconduct

University Ethics and Compliance Hotline:

866-364-1908

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


 

Before using the Human Subjects Protection Program forms, checklists, and templates, please read the guidance on Submitting to the IRB.  

Application for Review- These applications are for the review of new projects, both prospective research (use F200) and retrospective reviews (use F203), conducted by UA students, staff and faculty. There are also applications for ceding reviews to other IRB’s (use F204) and for researchers from other institutions that want site authorization (use F299) to access the UA students, staff and faculty.

Instructions for filling out Applications can be found here.   

Appendices- These appendices contain specific regulatory criteria when requesting waivers or the use of special populations. There are times when one or more of these applications may be required, please review the application that was completed to determine the correct form to submit.

Renewals- These forms are used for renewing Expedite and Full Committee projects for another year (use F212). Once the research is complete, the project can be closed out (use F212b). This form can also be used when needing to resolve any administrative closures.

Instructions for filling out Renewals can be found here.   

Amendment and Reportables- These forms are used for submitting changes to or problems with projects. To change personnel (use F109), update contact information (F215), or making protocol changes (F213). There is also an application to report information (events) that may be problematic to the conduct of the research to the IRB (F224). There is also a form for anything that needs to be acknowledged by the IRB (F216).

Instructions for filling out Amendments and Reportables can be found here here.   

Additional Forms- These forms are single documents that can be used with or may be required by any Application or Amendment. The Verification of Training Form (F107) must be included with all applications and changes to personnel. For individuals who are conducting research at a non-UA site, there is a site authorization template. For individuals who are looking for the Institutional Certification for NIH Genomic Data Sharing, the form can be found on this page. 

Consent Templates- These templates are for individuals who are constructing a consent document either with or without a participant’s signature. Also in this section is the University of Arizona-Banner Health Consent Form Template, which is required when conducting research at any of the BUMG sites or using BUMG patients.

Multi-Site Research- These forms are for human research conducted at more than one site that is external to the University of Arizona or affiliate institutions (e.g., Banner-University Medical Center Tucson, South and Phoenix campuses), where the University of Arizona is the IRB of record.