Download Forms

 

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 .
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.
Financial Interest Disclosure Form
Use this form to disclose to WIRB changes in previously reported financial interests.
Word 2000 Version


Recruitment Bonus Disclosure Form
Use this form to request approval of proposed recruitment bonuses for the PI or study team. WIRB defines a recruitment bonus as an additional payment or incentive provided to the PI or staff dependent solely on a particular number of subjects being enrolled, or dependent on the speed at which subjects are enrolled. The term payment or incentive includes any items of value, such as direct payment, gift certificates, travel vouchers, physical items such as watches, etc. 
 Word 2000 Version


Impartial Witness Form for Limited and Non-Readers
Unless consent has been waived or the protocol excludes enrollment of limited readers or non-readers, involve an impartial witness in the consent process when enrolling limited or non-readers and document the participation of the impartial witness using the designated signature lines on the WIRB-approved consent form. In the absence of designated signature lines, download and use the WIRB standard impartial witness form below.
PDF Version Word 2000 Version


Consent addendum for subjects originally enrolled as children who are now adults
Unless consent has been waived, WIRB requires you to obtain the consent of subjects who reach the age of majority during the research. You may use your current WIRB-approved consent form to obtain their consent , or, if the approved consent form does not have appropriate signature lines for doing so, you may download the attached consent addendum and present it, along with the current WIRB approved consent form, to the subject in order to obtain his/her consent.

If you use the addendum below, please remove the statement from it regarding authorization to use and disclose information if the consent form signed by the parent/guardian did not include an authorization section.

You do not have seek WIRB approval of the generic addendum before using it if you use it without alteration (besides removal of the authorization statement if appropriate as outlined above).
PDF Version Word 2000 Version



Sending the forms to WIRB
Please complete and return your form(s) to WIRB via ConnexusTM (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