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IRB Forms and Template

These tools and templates are intended as guidance only. Please contact the office of the IRB for further assistance at 616.486.2031 or email

Form Name Version Date
   Pre-IRB Submission Tools & Templates         
IRB Contact Roster 09/09/2014
Protocol Template  06/01/2010
Informed Consent Template 01/08/2015
Assent for Children Template  10/05/2011
Required Elements of Informed Consent and HIPAA  03/22/2010
   Human Research Guidance & Forms         
Letter to the Research Community 01/22/2010
   Short Forms/Translation Info         
Short Form - English (for reference only) SH FORM# x10866 09/11
Short Form - Spanish SH FORM# x10919  02/11
Short Form - Bosnian SH FORM#11233  03/11
Short Form - Vietnamese SH FORM#12817  05/11
Translation Request Form  10/03/2007
   General IRB Information          
Protocol Deviation Tracking Log - To be completed for minor protocol deviations at the time of Continuing Review. 

IRB FeesApplies to all studies where funding is available to support the IRB activities and includes but is not limited to submissions, continuing review, and amendments/substantial modifications. 


Letter of Compliance 01/20/2012

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