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VA Central IRB Forms: Investigator Forms

These are investigator-initiated forms and are grouped according to type of action being requested or reported.

« back to all VA Central IRB forms

VA Central IRB Initial Study and Continuing Review SharePoint Submission Instructions
New Study Application Forms
Form #TitleRevision Date
102Local ACOS / R&D Review SupplementJanuary 18, 2019
103Request for Waiver or Alteration of HIPAA AuthorizationApril 7, 2020
104Local Site Investigator ApplicationFebruary 12, 2019
104aCo-Local Site Investigator New Project Application SupplementMay 13, 2019
104 - NSILocal Site Investigator Application – No Subject Interactions February 12, 2019
105Request for Exemption of ResearchFebruary 5, 2019
108Principal Investigator/Study Chair New Project ApplicationMay 21, 2020
108Principal Investigator/Study Chair New Project Application — No Subject InteractionsJanuary 22, 2020
108aCo-Principal Investigator/Study Chair New Project Application Supplement
January 18, 2019
108a - DOECo-Principal Investigator/Study Chair New Project Application Supplement - DOE
January 18, 2019
108bCoordinating Center PI/SC New Project Application SupplementJanuary 18, 2019
110aVulnerable Population Supplement (Pregnant Women)January 18, 2019
110bVulnerable Population Supplement (Prisoners)January 18, 2019
112aRequest for Waiver or Alteration of the Informed Consent ProcessJanuary 15, 2019
112bRequest for Waiver of Documentation of Informed ConsentJanuary 15, 2019
n/aCombined Informed Consent/HIPAA Authorization Template April 7, 2020
n/aInformed Consent Template OnlyFebruary 5, 2020
118Request for Determining Whether an Activity/Project is Research and/or Human Subjects ResearchJuly 1, 2010
n/aInformation Sheet Template (Waiver of Documentation of Informed Consent)
January 21, 2019
n/aProtocol TemplateJanuary 21, 2019
n/aDeception in Research GuidelinesJanuary 21, 2019
Amendments, Protocol Exceptions, and Continuing Review
Form #TitleRevision Date
115aApplication for Continuing Review — Principal Investigator/Study ChairSeptember 18, 2019
115bApplication for Continuing Review — Local Site Investigator
November 21, 2019
116Request to Amend or Modify an Approved ProjectDecember 10, 2018
117aProject Closure ReportMay 16, 2017
117bLocal Site Project Participation Closure ReportAugust 7, 2017
127Request for an Exception to an Approved ProtocolJanuary 22, 2020
127aReporting of Protocol Exceptions Due to COVID-19 Safety PrecautionsApril 10, 2020
130Status Report Update for Studies Not Subject to Continuing Review ApprovalSeptember 18, 2019
134aChange in Principal Investigator/Study ChairJanuary 15, 2019
134bChange in Local Site InvestigatorJanuary 15, 2019
Reporting Requirements
Form #TitleRevision Date
119Report of Serious Adverse Events and Unanticipated Problems Involving Risks to Participants or OthersOctober 14, 2015
129Report of Protocol Deviations or ViolationsMarch 20, 2014

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