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VA Central IRB Forms: Member and Staff Forms

These are forms used by VA Central IRB members and staff to track VA Central IRB project status and to facilitate project reviews. Also included are forms pertaining to the appointment of members to the VA Central IRB.


« back to all VA Central IRB forms

Reviewer Checklists and Certification Forms
Form #TitleRevision Date
106Determining Whether Human Research is Exempt/Limited IRB Review (565KB, MSWord)February 14, 2019
111aReviewer Checklist for PI/SC New Project Application (882KB, PDF)April 19, 2019
111b Reviewer Checklist for Local Site Investigator Applications (160KB, MSWord)July 16, 2010
111cReviewer Comment Sheet (94KB, MSWord)January 11, 2013
113Reviewer Checklist for Informed Consent (418KB, PDF)April 19, 2019
114aReviewer Checklist for Continuing Review (PI/SC Application) (326KB, PDF)May 20, 2019
114bContinuing Review Checklist for Local Site Investigator Applications (119KB, MSWord)January 30, 2015
120 Reviewer Checklist for Amendments (203 KB, PDF)August 7, 2017
125Reviewer Checklist for Serious Adverse Events and Unanticipated Problems Involving Risks to Participants or Others (360 KB, PDF)December 5, 2017
128Reviewer Checklist Protocol Exceptions (143KB, MSWord)July 15, 2019
146 Checklist for Review of Protocol Deviations or Violations (1059 KB, PDF)Revision Date is July 20, 2017
152Documentation of Review By a VA Central IRB Co-Chair or Other Designated Reviewer (81 KB, MSWord)January 17, 2018
Administrative Review and Tracking Forms
Form #TitleRevision Date
N/A VA Central IRB Sample Meeting Minutes Template (64KB, MSWord)October 7, 2011
Member Appointment Forms
Form #TitleRevision Date
140 VA Central IRB Members' Evaluation of Co-Chairs (146 KB, MSWord)September 11, 2019
142VA Central IRB Member Evaluation (144 KB, MSWord)September 11, 2019

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