Institutional Review Board (IRB) Submission Forms and Helpful Information

Note: Forms are available in Microsoft Word format, so they can be downloaded, completed, saved and printed as necessary.

Preparing and Submitting Proposals to the IRB

• General IRB Information
• How to submit for IRB Review
• List of Required IRB documents

Note: For a complete discussion of University policies and procedures, please review Nova Southeastern University’s Institutional Review Board Web site at http://www.nova.edu/irb/

All IRB submissions will be paperless and submitted electronically on the ADRIANA student page. To submit the dissertation proposal for IRB approval, access the ADRIANA student page (http://apps.fischlerschool.nova.edu/ADRIANA/student/Login.aspx) and log on using your NSU email username and password. The IRB access button is near the top of the page. Paper submissions will no longer be accepted after December 1, 2009.

Document #1: Protocol Submission Forms

• Submission Form for Initial Review (document is required for initial review)
• Submission Form for Amendment of IRB Approved Studies  
• Submission Form for Continuing Review of IRB Approved Studies

Informed Consent Instructions

Note: Signatures on consent form(s) should not be obtained until after you have received IRB approval.  The IRB must review and approve your study prior to any participant solicitation.

• Consent Instructions
• Assent Instructions   
• Readability Instructions

Document #2: Consent and Assent Form Templates

Note: Studies may need to use only one or several of these forms, depending on the groups involved in the research. For example, if different procedures are used for teachers and parents, use two different consent forms. 

• Adult Consent Form Templates (choose one format)
• Document Template #1 for Adult/General Consent Form
• Document Template #2 for Adult/General Consent Form
• Child Assent Form Template
  • Document Template for Child Assent Form
• Adolescent Assent Form Template
  • Document Template for Adolescent Assent Form
• Parent/Guardian Consent Form Templates (choose one format)
  • Document Template #1 for Parent or Guardian Consent Form
  • Document Template #2 for Parent or Guardian Consent Form

Consent and Assent Form Models/Samples

• Adult Consent Form Models/Samples
• Document Model #1 for Adult/General Consent Form (Readability Score: Grade 6)
• Document Model #2 for Adult/General Consent Form  (Readability Score: Grade 8)
• Child Assent Form Model/Sample
• Document Model for Child Assent Form (Readability Score: Grade 3)
• Adolescent Assent Form Model/Sample
• Document Model for Adolescent Assent Form (Readability Score: Grade 5)
• Parent/Guardian Consent Form Models/Samples

• Document Model #1 for Parent or Guardian Consent Form (Readability Score: Grade 7)
• Document Model #2 for Parent or Guardian Consent Form (Readability Score: Grade 7)

Participation Letter
Note: To be used for anonymous surveying of Adults only.

• Document Template for Participation Letter

Document #3: Administration Letters

• Tips for obtaining the administration letter
• Sample administration letter to use ex-post facto/retrospective data
• Sample administration letter to conduct the study

Unanticipated Problem and Adverse Event Reporting

• Unanticipated Problem and Adverse Event Report form

Reminder: Be sure to include a copy of your CITI course completion report, approved proposal, data collection instruments, and recruitment materials (flyers, letters, etc.) with your IRB submission