IRB Application Forms

Human Subjects

  Application to Use Human Participants in Research MSWORD FILE

  IRB Policies and Procedures MSWORD FILE

      IRB Application Form RTF - Rich Text Format Downloadable  

Application to Use Human Participants in Research PDF FILE

IRB Policies and Procedures PDF FILE

 READ BEFORE SUBMITTING IRB - Application Submission Check List

IRB Renewal Form

Use this form when your research lasts longer than one year and you would like to continue the research protocol. This would be one year from your original IRB applications approval.

IRB Renewal Form MS WORD

PDF Renewal Form

IRB Protocol Change Form

Use this form for submitting changes to your originally approved IRB application. This includes any minor changes to your approved human subjects protocol. Minor changes are approved fairly quickly, but should the changes to your human subjects protocol be so extensive they change the the entire methodology then a new IRB application submission will be required.

IRB Protocol Change Form in MS Word

PDF Protocol Change Form

IRB Adverse Event Reporting Form

Use this form to submit a report of an unanticipated event (harm caused to human subject(s)), either an (AE) Adverse Event or a (SAE) Serious Adverse Event. No matter how minor the event. This is a mandatory federal requirement from the Office of Human Subjects Protections (guidance) that Adverse or Serious Adverse Events are required to be submitted and reported to the designated institutional IRB. Fill in the form and answer the questions and submit a copy to the IRB Coordinator in the Office of Academic Research, CSUSB, Room AD-179. Failure to notify the IRB of AE's or SAE's may result and disciplinary action by the CSUSB IRB under the CSUSB faculty and student misconduct policies in addition to notifying the Federal Office of Human Subjects Protections.

Adverse Event Reporting Form

Animal Subjects

  Application to Use Animals for Research or Teaching MSWORD FILE

  Animal Research Renewal Form MSWORD FILE

Application to Use Animals for Research or Teaching PDF FILE

Animal Research Renewal Form PDF FILE

Sample Forms

ATTENTION: The sample Informed Consent form is for reference only, please format your Informed Consent so that it is unique to the research protocol being conducted. Use the OHRP Informed Consent checklist (see bottom) to ensure you are including all the required elements of Informed Consent AND additional elements as appropriate. This will help in the processing, review, and final approval of your application.

 Sample Debriefing Form MSWORD FILE

 Sample Informed Consent Form MSWORD FILE - This sample was not intended to be used as boiler plate (to be copy and pasted). Write the informed consent in your own words appropriate to the survey population you are researching. See PDF copy for example and OHRP Informed Consent checklist below.

  Sample Video-Audio Informed Consent Form MSWORD FILE

Sample Debriefing Form PDF FILE

Sample Informed Consent Form PDF FILE

Sample Video-Audio Informed Consent Form PDF FILE

More On Informed Consent & Assent

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Please contact Michael Gillespie of the Office of Academic Research and CSUSB Institutional Review Board Coordinator if you have any questions regarding the IRB process or questions about this website at 909-537-7588 or email at mgillesp@csusb.edu

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