| Application Forms and Checklists (*indicates required for all applications) |
Instructions and/or Related Guidelines (if applicable) |
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| General Instructions |
CPHS Forms - General Instructions | |
| What to Submit - Forms Required for CPHS Submission | CPHS Forms - What to Submit | |
| CPHS Application Cover Sheet* |
Instructions | |
| CPHS Checklist for Financial Conflict of Interest: Human Subject Studies* (Students: your faculty advisor must sign this form! See instructions for more information.) UCB Human Subjects Financial Conflict of Interest Form (Submit if applicable with the CPHS Checklist for Financial Conflict of Interest.) |
UCB Conflict of Interest Committee Financial Conflict of Interest information Instructions |
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| Protocol Narrative Form |
Instructions | |
| Study Renewal/Continuation Form | Instructions | |
| Study Amendment Form | Instructions | |
| Request for Determination of Exempt Status | Instructions | |
| Notice of Intent to Rely on Another UC IRB for Review | see UCSF web site (under “Relying on Other IRBs”) | |
| Study Closure Form | Instructions | |
| HIPAA-Related Forms | ||
| HIPAA: UC Research Authorization for Release and Use of Personal Health Information and Personally Unidentified Study Data (for individual subjects)
HIPAA: UCB Waiver of Authorization |
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Health Insurance Portability and Accountability Act (HIPAA) |
| Other Human Research Forms | ||
| Medical Research Subject's Bill of Rights | ||
| Surrogates Consenting on Behalf of Incapacitated Adults (PDF) | UC Office of the President (UCOP) Guidance on Surrogate Consent for Research (PDF) | |
| Informed Consent | ||
| CPHS Informed Consent Guidelines 10/05 | ||