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Medical Institutional Review Board
Expedited Review Application
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INSTRUCTIONS:
There are seven sections to the IRB application. Depending on the nature of your research, some sections will apply to your research, some will not. Please review each section to determine applicability to your research, and include the Forms appropriate for your study in your IRB application submission. The number of copies required for submission of a complete application is noted below, and within the instructions for each section.
Each component of the application has been assigned a letter of the alphabet (as shown under the left-hand "Form" column). For each Form, there are guidelines/instructions to assist you in completing that component. When preparing your application, sort applicable materials alphabetically and then collate into the required number of packets (i.e. each packet has applicable forms A-Z). Un-collated or insufficient number of applications are subject to being sent back to the PI.
For your convenience, an Expedited Review Application Checklist [PDF] has been developed to assist you in assembly of your materials. Use is optional.
Note: The Sections include a combination of Forms to fill out, and guidance/ instruction for documents you may need to provide copies of or that you may need to develop. Forms to fill out (when applicable to your research) are denoted by the option to download either a WORD or RTF document.
Core Application - completion of A, A-1, & B is required
Include 3 copies of each.
Form A |
Click here for help (under construction) | |
| Form A-1 | Expedited Certification Form - REQUIRED [WORD] [RTF] Revised 7/24/07 | Form A-1 Instructions [HTML] |
| Form B | Research Description with Appendices [WORD] [RTF] Revised 7/20/12 | The WORD or RTF version may be saved to the location of your choice, and then used as a guideline while editing for your specific protocol. |
Informed Consent/Assent Process
You must select applicable item(s) from Form C - F and include 3 copies of each applicable item. If Form G and/or H apply, include 3 copies.
| Form C | Informed Consent Template: Informed Consent/HIPAA Combined Template: English-NEW 4/5/13 [WORD] [RTF]; Spanish-NEW 4/5/13 [WORD] [RTF] |
Form C Instructions [HTML] |
| Form D | Assent Form Template: Revised 6/22/07 |
Form D Instructions [HTML] |
| Form E | Request for Waiver of Informed Consent Process [WORD] [RTF] Revised 7/28/06 |
Form E Instructions [HTML] |
| Form F | Request for Waiver of Documentation of Informed Consent Process [WORD] [RTF] Revised 2/15/12 Cover Letter Template for survey/questionnaire |
Form F Instructions [HTML] |
| Form G | If Department of Health and Human Services (DHHS)-approved protocol (such as NIH-sponsored Cooperative Group Clinical Trial), attach the DHHS-approved Sample Informed Consent Form | Form G Instructions [HTML] |
| Form H | For recruitment of Non-English speaking subjects, attach translated consent document | Form H Instructions & info pertaining to subjects from a foreign culture [HTML] |
HIPAA (Health Insurance Portability and Accountability Act)
If HIPAA applies to your research, attach 3 copies of each applicable item. [visit ORI's Health Insurance Portability and Accountability Act (HIPAA) web page to determine if your research falls under the HIPAA Privacy Regulation.]
| Form I | HIPAA De-identification Certification Form [WORD] [RTF] Revised 11/16/12 |
Complete Form I if you plan to de-identify the data. |
| Form J | HIPAA Authorization Template: Revised 4/5/13 |
Use Form J to create your proposed HIPAA Authorization Form. Authorization Form Guidance [HTML] |
| Form K | Waiver of Authorization Guidance [HTML] |
Additional Study Materials
Complete/attach all of the below items that apply to your research; include 3 copies.
| Form L | Proposed advertisement(s) of any type for recruiting subjects |
Form L Instructions [HTML] |
| Form M | Proposed data collection instrument(s) (i.e., survey(s), questionnaire(s)) | Form M Instructions [HTML] |
| Form N | Off-site research [WORD] [RTF] Revised 7/21/09 | Form N Instructions [HTML] |
| Form O | Use of Any Drug* Being Tested in Research - Form *May include dietary supplements, or substances generally recognized as safe (GRAS) when used to diagnose, cure mitigate, treat or prevent disease |
Form O Instructions [HTML] |
| Form P | Use of Any Device Being Tested in Research - Form [WORD] [RTF] Revised 2/13/13 | Form P Instructions [HTML] |
| Form Q | Use of Radioactive Materials (Radiation Safety Form) [WORD] [RTF] Revised 4/19/05 | Form Q Instructions [HTML] |
| Form R | [previously for VA Form 10-1223] Click HERE for new information |
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| Form S | Copy of the package insert or FDA approved label (PDR reference) | Include for drug or device studies using the FDA approved medication/device for approved medical indication. |
Vulnerable Populations
Complete all of the forms below that apply to your research; include 3 copies of each applicable form.
| Form T | Adults with Impaired Consent Capacity: Web-Based Tool [to determine research risk level and likelihood of consent impairment] |
Form T Instructions [HTML] |
| Form U | Research Involving Pregnant Women, Fetuses, &/or Neonates [WORD] [RTF] Revised 8/2/06 |
Form U Instructions [HTML] |
| Form V | Form V Instructions & Suggested Consent Form Language [HTML] |
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| Form W | Form W Instructions [HTML] |
Materials for Primary Reviewer and Detailed Protocol/Grant Application Review
Attach 3 copies of each applicable item. Note an original of Form Z is also required.
| Form X Form Y | Note "Form X" and "Form Y" for Disclosure of Financial Interest (DFI) have been replaced by a question in "Form A" and the Office of Sponsored Projects Administration (OSPA) online financial disclosure form. | Instructions for OSPA's online financial disclosure form [PDF] OSPA's Disclosure of Financial Interest Survey Sample [PDF] |
| Form Z | 1 Original and 3 copies Form Z Instructions [HTML] |
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| Form AA | Grant/Contract Application |
Attach if seeking a grant or a grant received. |
| Form BB | Sponsor's detailed drug protocol and/or the complete Department of Health and Human Services (DHHS)-approved protocol (such as NIH-sponsored Cooperative Group Clinical Trial) |
Attach if conducting research involving administration of drug(s). |
| Form CC | Investigator Brochure |
Attach if conducting research involving administration of drug(s) |
| Form DD | Device/detail protocol proposal | Attach if conducting research involving the use of a device(s). |
NOTE: The Office of Research Integrity will forward to the University of Kentucky Hospital Investigational Drug Service (IDS) the detailed protocol and IRB application form per UK Hospital Policy on drug research. Please contact the IDS at 859-323-6969 for additional information. IDS may contact investigators directly if additional documentation is needed to meet Hospital policy.
Other Required Committee/Review Approvals
For research falling under the purview of any of the below committees or offices, attach 3 copies of the review or final approval materials (1 for IRB records, 1 for the IRB Primary Reviewer, and 1 for the Committee).
| Form EE | Institutional Biosafety Committee (IBC) |
Form EE Instructions [HTML] |
| Form FF | Radioactive Drug Research Committee (RDRC) |
Form FF Instructions [HTML] |
| Form GG | [previously for Markey Cancer Center (MCC) Protocol Review Committee (PRC)] -- 3/18/10: IRB Review is independent of PRC Review |
See Other Review Committees Info: [HTML] |
| Form HH | [previously for GCRC but no longer in use] |
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| Form II | Medical Center/College of Medicine | [For involvement of Medical Center students and/or College of Medicine students as research subjects.] Form II Instructions [HTML] |
| Form JJ | [previously for Veterans Affairs Research & Development Committee (VA R&DC)] Click HERE for new information |
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In accordance with federal regulations, a research study can be reviewed through an expedited review procedure if:
- the research activities involve no more than minimal risk;
- the only involvement of human subjects is in one or more of several specified categories.
In addition, the IRB may also use the expedited review procedure to review minor changes in previously-approved research during the period for which approval is authorized.
Under the expedited review mechanism, the review is carried out by an experienced member(s) of the IRB. The reviewer(s) may exercise all of the authorities of the IRB, except that he/she may not disapprove the research.
A summary of the expedited review procedures is provided below:
- The preliminary determination that a research project is eligible for expedited review is made by the investigator. The EXPEDITED CERTIFICATION FORM (Form A-1) serves as a guide in making this determination. In addition, questions of interpretation may be directed to the Office of Research Integrity (859-257-6071).
- The investigator prepares an application following the instructions as specified on the Expedited Review IRB application instructions page.
- 3 copies of the Expedited Certification Form (Form A-1) should be completed and included in the application submitted to the Office of Research Integrity, 311 Kinkead Hall. Applications may be submitted at any time. There are no deadline dates to meet as the review process is initiated upon receipt of the application.
- The application is sent to the designated reviewer upon receipt in the Office of Research Integrity. The investigator is not required to appear before the IRB.
- The review process takes approximately two weeks. The outcome of the review usually falls into one of the following categories:
- protocol approved as submitted;
- approval withheld pending submission of revisions and/or additional information;
- protocol requires full review.
- The Office of Research Integrity notifies the investigator in writing of all IRB decisions.
Note that all incomplete IRB applications will not be scheduled for review but returned to the PI. If you have questions concerning submission of a research protocol for IRB review, please call the Office of Research Integrity at 859-257-9428.