You must have Microsoft Word to view and edit these document.

Application forms

IRB application form - This form contains the detailed information about the research you are proposing. This document should be well thought out, complete and comprehensive. It will be used for both the Research Department (RD) and the Institutional Review Board (IRB).

After completing this form, please call the Research Department at 651-232-5363 to schedule a meeting to discuss your proposal. We will help to answer any questions that you may have and work with you to complete the application.

IRB Application Short form - This form is to be used for studies derived from HealthEast IRB approved registries or databases.

If IRB approval is required

If IRB approval is required for this project, your completed application form must be submitted to the IRB at least two weeks prior to the IRB meeting. Get IRB meeting dates. Your attendance at the IRB meeting is required for IRB approval. You will be contacted by the IRB for the exact meeting time and location, or you may call the Research Department at 651-232-5800 for a meeting schedule.

Financial disclosure forms

HealthEast provides forms to indicate any financial information relating to this project. If you or anyone involved with the proposed research will be receiving any monies for the project, the information must be disclosed on this form. Please chose the correct form for your status; HealthEast employee, HMRI doctor, or non-HealthEast person seeking to do research at HealthEast.

HealthEast Employee Research Financial Disclosure form

HealthEast Medical Research (HMRI) Employee Financial Disclosure form

HealthEast Medical Research (HMRI) Employee Financial Disclosure form

More forms

Consent template

HIPAA Authorization template

Project Evaluation and Review form - This form must be completed once per year after the project is approved. It provides the Research Department and the IRB an annual update as to the status of the project.

Database Application - This form is to be used for establishing a research registry/database.

Serious Adverse Event (SAE) form - This form is to be completed for any experience that is unexpected and suggests a significant hazard, contradiction, side effects, or precaution to the research subject.

Policies

HealthEast Research Policy (111b23.doc) – this is the policy document regarding research at HealthEast. It is simply provided for your reference. There is nothing to complete on this form.

Human Subjects Research Education Policy - This is a policy document regarding training for principal investigators on human subjects research. It is simply provided for your reference. There is nothing to complete on this form.