Forms

Forms 2017-07-11T13:54:16+00:00

This page contains downloadable links to all of Midlands IRB’s submission forms. All forms are copyright protected, and are in either Word or fillable PDF format. After completing and saving a form on your computer, you may then upload it to MyConnexus.

Accessing Smart Forms
To access a smart form from the list below, click the “Download” link next to the form name.

If your browser shows a page that says, “Please wait…If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.” Please ignore this message and ignore the instructions to upgrade Adobe Reader. Go to your Downloads folder. You will find the form there and can open with Adobe Reader or Adobe Acrobat. If you cannot find or open the form, please contact us at 913.385.1414.

Questions?
For questions or assistance while using or submitting these forms, please call us at 913.385.1414, or email info@mlirb.com.

PDF Forms

PDF Forms

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Initial Review Submission Form 490.08 KB 253 downloads

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IRB Authorization Agreement 63.14 KB 35 downloads

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PREGNANT PARTNER CF Template 91.85 KB 29 downloads

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Investigator Summary Report 73.77 KB 70 downloads

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Investigator Summary Report (HDE) 79.11 KB 22 downloads

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Hospital/University Waiver 23.05 KB 13 downloads

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HIPAA Authorization 50.94 KB 23 downloads

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HIPAA Waiver 36.07 KB 16 downloads

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Experimental Subjects Bill Of Rights 44.89 KB 246 downloads

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Sponsor/CRO Information Form 80.46 KB 35 downloads

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Sponsor/CRO Continuing Review Form 85.19 KB 57 downloads

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Unanticipated Event Form 149.85 KB 60 downloads

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    Word Forms

    Word Forms

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    Informed Consent Template 46.50 KB 50 downloads

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    IRB Authorization Agreement 37.50 KB 28 downloads

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    PREGNANT PARTNER CF Template 64.50 KB 23 downloads

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    Investigator Summary Report 86.00 KB 64 downloads

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    Investigator Summary Report (HDE) 67.00 KB 30 downloads

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    Hospital/University Waiver 55.00 KB 21 downloads

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    HIPAA Authorization 52.00 KB 22 downloads

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    HIPAA Waiver 38.00 KB 12 downloads

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    Sponsor/CRO Information Form 95.00 KB 25 downloads

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    Sponsor/CRO Continuing Review Form 67.00 KB 44 downloads

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    Unanticipated Event Form 804.50 KB 40 downloads

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