Download Social/Behavioral/Educational Forms
SBE Application Form
Must be submitted through BRAAN2
Case Report/Non-Human Subjects Research/Oral History Projects
Must be submitted through BRAAN2
Consent Templates
- ICF {main} template revised 05/03/2012 [Microsoft Word]
- ICF {main} checklist V.9/05 [Microsoft Word]
- ICF {main} template for Dept. of Education funded studies or Public School System [Microsoft Word]
- ICF {preamble} V.10/05 [Microsoft Word]
- ICF {assent} V3/09 [Microsoft Word]
- Oral History Sample Consent Template 1-18-2013 [pdf]
HIPAA Forms
- Authorization and Revocation Form [Microsoft Word]
- Authorization and Revocation Form (Database and/or Biorepository) [Microsoft Word]
- Partial Waiver Form [Microsoft Word]
- Complete Waiver Form [Microsoft Word]
Additional Current Forms
- Amendment Request Form V8/06 [Microsoft Word]
- Closed to enrollment form V4/07 [Microsoft Word]
- Completed study form V3/12[Microsoft Word]
- Local SAE form [Microsoft Word]
- Progress Report/Continuation Request Form V. 8/08 [Microsoft Word]
- Protocol Deviation/Violation Form [Microsoft Word]
- Unanticipated Problems Involving Risks to Subjects or Others (UPIRTSO) V.4/07 [Microsoft Word]
- Human Subjects Payment Request Form [Adobe PDF]
Information about Conducting Research in the Jefferson County Public Schools
http://www.jefferson.k12.ky.us/Departments/AcctResPlan/ResFormPref.htm
Research Request Form for Jefferson County Public Schools & Conditions Related to Conducting Research in the Jefferson County Public Schools
http://www.jefferson.k12.ky.us/Departments/AcctResPlan/ResearchRequest.htm
Download Instructions for Microsoft WORD/Excel Documents:
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Click on the link and select "Save"
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A dialog box will appear and you will be prompted to save the file to your computer. Choose a location to save the file.
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Open the file from your computer using Microsoft Word or another compatible word processing program and complete the application form.
Mail or deliver to:
Human Subjects Protections Program Office
University of Louisville
501 E. Broadway, STE 200
Louisville, KY 40202
Or on campus:
Human Subjects Protection Program Office
HSC, MedCenter One
