Templates & Forms

The following protocol and consent templates are used by researchers in preparation for IRB submission (see Investigator Manual for additional guidance on completing these documents). Additional IRB templates are provided to promote transparency of IRB operations. HIPAA and data use agreements are not part of the Toolkit and can be found in the Contracts Library.

Download Frequently Accessed Forms & Templates:

 
 

Protocols

NumberTitleUpdated
503Human Research Determination FormAugust 2024
508Local Protocol Addendum - With Instructions
Local Protocol Addendum - No Instructions
August 2024
580Social Template Protocol - With Instructions
Social Template Protocol - No Instructions
August 2024
590Medical Template Protocol - With Instructions
Medical Template Protocol - No Instructions
August 2024
591HUD Template ProtocolAugust 2019
595Data or Specimen-Only ProtocolAugust 2024
597Database, Registry, and Biospecimen Repository ProtocolAugust 2024

 

NumberTitleUpdated
506Consent Form Template for Emergency UseAugust 2019
507

Consent Short Form Template (English)

Consent Short Form Template Translations: Certificates of Translation

June 2024
582Consent Form Template for Social/Behavioral ResearchAugust 2024
583Assent Form TemplateDecember 2023
584Assent Script TemplateMarch 2017
587Information Sheet for Exempt ResearchJuly 2024
588Combined HIPAA and ConsentAugust 2024
589Consent Collection After WithdrawalAugust 2019
592Consent Form Template for Medical ResearchAugust 2024
593Multi-Site Master Consent FormAugust 2024

 

Other Templates

NumberTitleUpdated
504School Permission to Conduct ResearchAugust 2019
537Business and Industry Funded Study FeeMarch 2021
538Scientific ReviewApril 2019
574Certification of Attestation of TranslationJune 2018
988Referral Information Sheet for Research ParticipantsDecember 2023
5000

HIPAA Authorization Forms:

June 2021
5001Data Use AgreementsJune 2021

 

IRB Operations

NumberTitleUpdated
501MinutesJune 2024
515Letter—Suspension or TerminationAugust 2024
519Letter—Information ItemOctober 2022
520External Report - All Agencies Not Including OHRPAugust 2024
520aExternal Report - All Agencies w/OHRPAugust 2024

 

Forms

IRB staff and members use these documents as a reference when reviewing IRB submissions.

NumberTitleUpdated
210Expert ConsultJune 2017
215Ombudsman Report FormJanuary 2020
216External Team Member FormAugust 2024
223Confidentiality Agreement for AttendanceAugust 2024
226MacCAT-CR Assessment FormJan 2018
227UBACC Interview FormJan 2018
229Request to TransferAugust 2024
230HRPP Education Session Evaluation FormAugust 2019
810Participating Site Local Context and Institutional RequirementsJuly 2024
811Basic Site InformationJuly 2024
812Site Continuing ReviewJuly 2024
813Site ModificationJuly 2024
814Site New InformationJuly 2024
815Institutional ProfileJune 2024
817Site ClosureJuly 2024
821Participating Site ListJune 2021
823ADVARRA Institution Cover PageMarch 2023
828Attestation of PI Responsibilities when UMN IRB Serves as sIRBAugust 2024
829PI Attestation Form for Reliance on an External IRBAugust 2024
833Local Compliance AssessmentDecember 2023
855Individual Investigator Agreement for Federally Funded ResearchOctober 2022
856Individual Investigator Agreement for Non-Federally Funded ResearchOctober 2022
1899Sponsor Investigator ResponsibilitiesJuly 2024


Share feedback or suggestions regarding how to improve these Toolkit documents, including the protocol and consent templates: HRPP Toolkit Feedback Form.