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Many of WIRB's Word-format submission forms are now retired and replaced with dynamic, PDF-based submission forms!  
 
New pdf-based smart forms are now available below for sending initial reviews, changes in research, promptly reportable information, and study closure information.
 
Please note the following about our improved forms:
  • The smart forms must be completed using either Adobe's free Reader or Adobe Acrobat (version 9.1 or newer). Use of a program other than Adobe (version 9.1 or newer) to view or complete the forms will result in missing questions and non-functional fields.  To download Adobe Reader for free, please visit https://get.adobe.com/reader/. (If you do not have access to Adobe's Reader or Acrobat, you may continue to submit the Word-format forms. In the near future we will be making available an html5 [online] version of the forms that do not require Adobe software.)  
  • Because these smart forms are dynamic (change based on your responses), they must be completed electronically; therefore, you cannot print them out and complete them on paper. However, at any time during their completion, you can edit, save, print, or share with your colleagues.
  • We will continue to accept the old forms until futher notice.
  • The new forms have been adopted by WIRB, NEIRB, and CGIRB -- the smart pdf forms below can be submitted to either WIRB or CGIRB.
A brief orientation and tutorial on the new forms is available here:  http://www.cgirb.com/wp-content/uploads/2015/12/WCG-SMART-Forms-Training-Guide.pdf 
The forms below provide WIRB with all the required IRB review information required.  Please provide a submission form with each protocol you submit for review. 
 
For questions or assistance, please see the WIRB Guide for Researchers available below, call 1-800-562-4789, or email clientservices@wirb.com.
New Jersey Requirements for Inclusion of Decisionally Impaired Subjects (New Jersey Statute 26:14-5)
New Jersey Statute 26:14-5, also called the Access to Medical Research Act (included at the end of this form), requires an investigator to provide additional protections for subjects who are unable to consent for themselves. The questions on this supplemental form will assist the Board in determining whether your site will provide the required safeguards.
Word 2000 Version


Request for a Partial Waiver of Authorization for Recruitment (HIPAA Partial Waiver of Authorization)
Researchers should use the WIRB Partial Waiver of Authorization submission form to request approval of access to Protected Health Information (PHI) for recruitment. For more information, please see the HIPAA page in the Guide for Researchers. 
Word 2000 Version


Request for Full Waiver of Authorization under HIPAA
Researchers should use the WIRB Full Waiver of Authorization submission form to request approval of access to Protected Health Information (PHI) for the entire research project. For more information, please see the HIPAA page in the Guide for Researchers. 
Word 2000 Version


IRB Transfer Cover Letter Checklist & Summary Form
Waiver of Consent Request for In Vitro Diagnostic Device Studies Using Leftover Human Specimens That Are Not Individually Identifiable
Based on FDA guidance issued April 25, 2006, WIRB will consider requests for waivers of consent for in vitro diagnostic device studies using leftover human specimens that are not individually identifiable. Complete the form below and send it with your submission. 
Word 2000 Version


Sample IRB Authorization Agreement (with WIRB filled in as institution A)
Investigator Confirmation of Board Requirements
Initial Review Submission Form Addendum  for Department of Defense Funded Research
Locations With Obligations to other IRBs
If one or more research locations has an obligation to use another IRB, WIRB can engage in an agreement with another IRB to:
  • Provide complete dual oversight of research with the other IRB, in which both IRBs provide initial and continuing review of all aspects of the research. Please have the other IRB complete the template agreement and then submit to us:

Word 2000 Version (Canadian version: Word 2000 Version )  

  • Provide split dual oversight of the research with the other IRB, in which WIRB provides IRB oversight for specific physical locations, and an institutional IRB provides IRB oversight of the aspects of the study conducted at the institution. Please have the other IRB complete the template agreement and then submit to us:

Word 2000 Version

or

  • Assume jurisdiction from an existing institutional IRB for the review of a study or studies. Please have the other IRB complete the template agreement and then submit to us:

Word 2000 Version


Sending the forms to WIRB
Please complete and return your form(s) to WIRB via Connexus (https://connexus.wcgclinical.com/default.aspx), e-mail, fax, or postal mail.

WIRB
1019 39th Avenue SE Suite 120
Puyallup, Washington 98374-2115
USA
E-mail: clientservices@wirb.com
Fax: (360) 252-2498