Contact Information

Organization

THE COMMITTEE ON HUMAN RESEARCH (CHR)

APPLICATIONS AND FORMS

CHR Forms available in MS Word 6.0 Format (Windows and Mac). Just click on the link you wish to download. If you experience any technical problems accessing these files please contact us.

Full Committee Review Application
•	Full Committee Review Application Form - Updated October 2008
•	Submission Checklist
•	Supplements:
	•	Departmental Scientific Review Form
	•	Emergency Medical Research Waiver of Informed Consent
	•	Human Stem Cell Research
	•	Inclusion of Children and Minors
	•	Inclusion of Prisoners
	•	Non-Significant Risk Determination for an Investigational Device
	•	Surrogate Consent
	•	Human Biologic Specimen Collecting and/or Banking for Future Research
	•	Waiver of Informed Consent/Authorization for Minimal Risk Research or Screening
	•	Disclosure of Investigators' Financial Interests Supplement
	•	Human Gene Transfer / Recombinant DNA Research Supplement
	•	IRB Approval Certification for UCSF Researchers Involving Non-UCSF Affiliated Sites
	•	Notice of Intent to Rely on One UC IRB
	•	San Francisco Veterans Affairs Medical Center (SFVAMC) Supplement for Continuing Review of Approved Research
Expedited Review Application
•	Expedited Review Application Form - Updated October 2008
•	Expedited Review: No Subject Contact Application Form
•	Submission Checklists
	•	for Expedited Review Application Form
	•	for Expedited Review; No Subject Contact
•	Supplements
Obsolete Application - Full Committee and Expedited Review - Use only for Renewal and Modification of Studies Originally Submitted Using These Forms
•	CHR Cover Page
•	Full Committee Review Format Template
•	Expedited Review Format Template
Modification Forms
•	Status Report for Renewals and Major Modifications (Continuing Review)
•	Checklist for Renewals and Major Modifications (Continuing Review)
•	Modification Request for Minor and Administrative Changes
•	Checklist for Minor and Administrative Changes
Renewal Forms -
•	Status Report for Renewals and Major Modifications (Continuing Review)
•	Checklist for Renewals and Major Modifications (Continuing Review)
•	Supplements
Exempt Certification Forms
•	Category 1, 2, 3: Research conducted in educational settings or evaluating surveys
•	Category 4: Biological specimens, records review or data analysis
Non-Human Subjects Research - NEW
•	Self-Certification for Non-Human Subjects Research Form
Administrative Review for Human Research Studies Not Being Conducted by a UCSF Principal Investigator But Accessing UCSF Facilities, Patients or Personnel (Faculty, Staff, or Students)
•	Administrative Review Form
Adverse Event and Other Safety Information Reporting
•	External (off-site) Adverse Event Report
•	Internal (on-site) Adverse Event Report
•	Reporting Form for Investigator Brochure, Safety Information or Publication, DSMB/DMC Report, Audit Report, and Hold on Study Activity
•	Adverse Event (AE) Summary Log
Protocol Violation or Incident Reporting
•	Protocol Violation or Incident Reporting Form
Study Close-out Reporting
•	Study Close-out Reporting Form
Emergency Use and Compassionate Use of Experimental Drugs and Devices
•	Emergency Use Written Report Form
•	Emergency Use Compliance Checklist
Human Stem Cell Research
•	Human Stem Cell Research Supplement
NIH Form
•	Protection of Human Subjects Assurance Identification/IRB Certification/Declaration of Exemption
Sample Consent and Assent Forms
•	Consent and Assent Form Formats
•	Consent Form Templates (in process of revision)
HIPAA Forms
Experimental Subject's Bill of Rights
•	To download, click on the language below ( )
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