UK Office of Research Integrity

Menu

ORI Home Page

 

 

?

Interested in the ethical conduct of human research? Want to know more about the IRB process? Then become an IRB member! The Office of the Vice President for Research and ORI appreciate volunteers and are always on the look out for interested and committed members. Contact Judi Kuhl for more information (859-257-9764).

Human Research Forms
Index

NEW! E-IRB Information (web-based IRB application) NEW!

 

Initial Review

Medical IRB

  • Medical Expedited Review Application [HTML]
  • Medical Full Review Application [HTML]

Nonmedical IRB

  • Nonmedical Expedited Review Application [HTML]
  • Nonmedical Full Review Application [HTML]

Exemption Certification Request (application) [HTML]

If you are completing an IRB Application for research involving human subjects, please visit ORI's Health Insurance Portability and Accountability Act (HIPAA) web page to determine if your research falls under the HIPAA Privacy Regulation.

Send IRB materials to:

Office of Research Integrity
315 Kinkead Hall
University of Kentucky
Lexington, KY 40506-0057
Ph: (859) 257-9428
FAX: (859) 257-8995
Hours of Operation: 8am-12pm; 1pm-5pm


All Other Human Research Forms

    Click here for free Acrobat Reader software, needed for opening PDF links. PDF links on this page are set to open a new web page.

  • Modification Request Form [WORD] [RTF] Revised 1/13/14

  • Study Personnel List Template [WORD] [RTF] Revised 8/30/13

  • Protocol Violation Form [WORD] [RTF] Revised 1/7/11

  • Continuation Review Report Form (SAMPLE) [PDF] Revised 9/2013

  • Emergency Use Checklist [WORD] [RTF] Revised 7/24/07

HIPAA

  • HIPAA Authorization Template [WORD] [RTF] Revised 10/22/12

  • HIPAA De-identification Certification Form [WORD] [RTF] Revised 11/16/12

  • HIPAA Waiver of Authorization Form [WORD] [RTF] Revised 8/21/07

Unanticipated Problem/Adverse Events (Effective starting June 15, 2006)

  • Internal Prompt Reporting Form [WORD] [RTF]

  • External Prompt Reporting Form [WORD] [RTF]

  • If a PI recognizes that a problem/event does not meet the prompt reporting requirements, but the sponsor has requested reporting to the IRB, the PI may send the sponsor the IRB’s letter of explanation about the UK IRB policy on review of events: Letter for Sponsors [PDF]

  • If the sponsor, after receiving the "Letter for Sponsors" (above), still requires the PI to submit reports to the IRB that do not require prompt reporting according to UK’s policy, the PI may complete the “Cover Form for Non-Prompt Reporting of Problems/Events”: Cover Form for Non-Prompt Reporting of Problems/Events [WORD] [RTF]

  • Unanticipated/Anticipated Problem/Adverse Event Reporting SOP [PDF] Revised 9/24/10
  • Policy on Prompt Reporting for Unanticipated/Anticipated Problems/Events [PDF] Policy Effective June 15, 2006

 

Back to Top