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Social & Behavioral Research: Forms & Consent Templates

This section contains all of the forms and consent templates that apply to investigators from: 

  • Business
  • Education
  • Engineering
  • Humanities & Sciences
  • Law

*Please note that when creating a protocol for IRB submission, these investigators need to select the Non-Medical eProtocol Application category.

* Any study that involves the collection and analyses of human biological specimens and/or Protected Health Information (PHI) will need to be submitted on the Medical eProtocol application.

For questions, please contact the Non-Medical IRB Panel Staff.  If you are having trouble accessing these forms, please ask IRB Education (email or call 650-724-7141) to have them sent to you.

Templates:

   Consents 
        See consent template updates for recent changes
Consent
docx
9/2018
Research Information Sheet - Use for Waiver of Documentation
docx
9/2018
Parent or Legally Authorized Representative Permission
docx
9/2018
Video Use Consent
doc
2/23/16
   Assents, phone screens, scripts 
        See consent template updates for recent changes
Assent – under 18
doc
1/7/15
Telephone Screening of Potential Subjects
  • Sample Phone Screen Level 1a
  • Sample Phone Screen Level 1b
• Guidance
• Screen1a
• Screen1b
Oral Consent Script
docx
9/2018

 

Other Forms:

    HS Research Determination; Other
Human Subject Research (HSR) Determination Form
Letter of Agreement - for research in cooperation with other organizations

 

    Scientific Review
Review of Scientific and Scholarly Validity, and Oversight (by Academic Sponsor)
Review of Scientific and Scholarly Validity (by Dept Chair or School Dean)

 

eProtocol Forms:

   Required Attachments
International Research Supplemental Questions – research outside the US
DOE-supported research: Protection of Personally Identifiable Information (PII)    [Form APP-14]
  Blank eProtocol Application Forms

      New, Modification, Continuing Review

  (These are for informational purposes only)
• New: 
    -Regular 
    -Expedited
    -Exempt
• Mod
• Continuing Review
eProtocol is used to submit:
  • New Protocol applications - see examples above.
      - Complete and attach supplemental required attachments as needed (see above)
  • Modifications to approved protocols (need prior IRB approval to implement).
  • Continuing Review applications.
  • Reports unanticipated problems, events/information requiring prompt reporting.
  • Final Reports (not required for Exempt research).