You will need to initiate a new protocol through the UVMClick – IRB module. This will require that you complete a General SMARTForm and attach completed consent forms/documents as applicable.
Initial Submission
Expedited & Full Board Applications
| Protocol Forms | Use | Version |
|---|---|---|
| Human Research Protocol (DOCX) | For any human subjects study that does not have a specific “protocol” from the sponsor. | 06/21/23 |
| Qualitative Research Protocol (DOCX) | To be used if the research is purely qualitative. If there are any medical procedures use the Human Research Protocol. | 10/06/23 |
| Biological Specimens/Data Repository Protocol (DOCX) | When the only activity is the collection, storage, and distribution of data or specimens for research. | 08/14/23 |
| Blood Collection Protocol for Non-Clinical Laboratory Research (DOCX) | When the only activity is blood collection for bench science. | 12/07/23 |
| Exception From Consent For Emergency Research (DOCX) | Supplementary form to be used when submitting an emergency research protocol. | 07/25/2023 |
| Grant Proposals Lacking Definite Plan for Involvement of Human Subjects (DOC) | Only use when a human subject activities are delayed but an IRB certificate is required from the sponsor | 06/21/23 |
| Supporting Document Templates | ||
| Institutional Support Letter | This template can be used to obtain signatures from an executive director, chief executive officer, board president, or other individual with authority to commit the institution's resources, acknowledge the proposed research activity, and grant permission for the engagement of their employee and facilities in that activity. | 02/13/2020 |
Exempt Applications
| Determination Forms | Use | Version |
|---|---|---|
| Exemption 1 (DOCX) | Educational Research | 10/26/22 |
| Exemption 2 (DOCX) | Surveys and Interviews | 05/12/23 |
| Exemption 3 (DOCX) | Behavioral Interventions | 10/26/22 |
| Exemption 4 (DOCX) | Secondary Data Uses | 4/4/24 |
| Exemption 5 (DOCX) | Demo Projects | 1/11/21 |
| Exemption 6 (DOCX) | Food and Taste | 10/26/22 |
Data Management & Security Plan
The DMSP is required to be completed as part of an expedited, full board, exempt 2(iii), 3(i)(C), 4(iii) and all Single IRB submissions.
Research Data Management and Security Plan (DOCX)
Projects Not Requiring IRB Review
Use the self determination tool to see if your project requires IRB review and submission to the Research Protections Office.
Projects Not Requiring IRB Review ToolRequest to Rely on Single-External IRB
Request to Rely
Request to Rely on External IRB (DOCX)
Consent/HIPAA Checklist for Required Language (DOCX)
Documentation of Waiver or Alteration of HIPAA Authorization (DOCX)
HIPPA Authorization Template (for External IRB Studies When UVM is the Privacy Board)
Consent Information
2018 Common Rule Guidance
A concise summary of study activities, risks, and benefits presented to research participant in advance of the body of the consent form is now required as part of the 2018 Common Rule change for any new protocol or active protocol where subjects are still being enrolled. The IRB will not require re-consent for subjects already enrolled.
Additionally, there are new elements of informed consent that are required as applicable. These can be found in the UVM sample consent template document in BLUE text.
Examples of the new concise key information section (DOCX)
View the HIPAA and Research FAQ (opens in a new window)
Search for a term in the Medical Dictionary (opens in a new window)
Informed Consent Templates
| Consent Forms | Updated |
|---|---|
| Adult Behavioral/Social Study Consent (DOCX) | 09/30/22 |
| Medical Study Consent (DOCX) | 04/03/23 |
| Child Assent (DOCX) | 03/24/21 |
| Debriefing Consent (DOC) | 11/08/19 |
| Information Sheet (DOCX) | 09/29/22 |
| Media Consent (DOC) | 10/06/03 |
| Pregnant Partner Consent (DOCX) | 10/23/2020 |
| Repository Consent Template | 06/13/2023 |
| Expanded Access Consent (DOCX) | 04/20/21 |
| Screening Consent Script Template (DOCX) | 11/02/2020 |
Short Form
Consent Process Documentation Examples
| Documentation Forms | Updated |
|---|---|
| Example 1 (DOCX) | 08/31/23 |
| Legally Authorized Example (DOCX) | 08/31/23 |
Ongoing Consent Templates
Consent Addendum
To be used anytime you have some additional information for subjects that may affect their willingness to continue participation. Prior IRB review and approval is required.
Continued Participation After Child Reaches 18 years of age
To be completed with the child who has now turned of age. You must review the originally signed consent with the now adult child and obtain consent to continue their participation.
Continued Participation after Reaching Age of Majority (DOCX)
Updated 6/13/23
Related Documents & Resources
Data Use Agreement
Where faculty are receiving or sharing human subject data as part of a research collaboration, they will need to ensure that an appropriate Data Use Agreement or other form of research collaboration or confidentiality agreement is in place.
Contact spa@uvm.edu for more information.
Limited Data Sets
If the research includes use of a limited data set from the UVM Medical Center, you must enter into a Data Use Agreement with the hospital
(opens in a new window).
UVMMC Reviews Preparatory to Research
Attestation for Decedent Research
If your research uses decedent UVMMC PHI, fill this form out and send to Jennifer.Parks@uvmhealth.org.
Accounting of Disclosures of Protected Health Information