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Forms and Policies
Other IRB Forms
Incident Report Form
Seattle Children's Research Institute/PedCIRB Intent to Open New Research Study via NCI CIRB Independent Model
PedCIRB Potential Unanticipated Problem or Serious or Continuing Noncompliance Form
Memorandum to Add Funding Proposal
To be used when human subject activities already approved by the IRB are referenced in a new funding proposal that is being submitted to an external funding agency.
This form is no longer in use.
Please refer to the revised
Modification Request Form
(DOC) if a new funding proposal is being submitted to an external funding agency.
Memo of Understanding Concerning Children's IRB Review Fees
, revised June 26, 2009 (DOC)
This form is completed by the researcher when the funding is based outside of Children's and IRB fees apply. IRB fees apply to all research studies funded by for-profit (corporate) sponsors.
IRB fees also apply to research studies funded by private, non-profit or public sponsors when the funding is based at an institution other than Children's, the University of Washington or the Fred Hutchinson Cancer Research Center.
IRB Criteria and Considerations
This document lists the IRB approval criteria and considerations for IRB review.
Letter of Support Template
This is provided as a simple template for optional use when researchers need a letter of support/cooperation from departments/clinics/institutions for their research project.
Optional Protocol Templates (all files are DOCs)
The following protocol templates and guidelines are provided as resources to researchers who want to create their own protocols for studies. Use of these templates is
optional for submission purposes
Basic Protocol Template
Behavioral Interventional Protocol Template
Biomedical Interventional Protocol Template
Observational Protocol Template
Guidelines for Protocol Writing
Research Participants' Rights
This one-page handout outlines in lay language the rights of research participants. Use with the short-form consent prepared for language minorities.
Also useful to hand out to research participants and can be used with any research study as part of the consent process.
Request for Tissue for Use in Research
For any of the research scenarios listed below, please fill out a
RLS New Study form
and check the box for "Requires Pathology review of study tissue requirements."
If your research project involves the use of tissue collected from Seattle Children's patients
If your research will use tissue to be collected prospectively, i.e., tissue that will be removed during a scheduled surgery or procedure
If your research will use tissue that has already been collected from patients and stored (archived)
Genome-Wide Association Studies Supplement
The GWAS supplement has been replaced with a new
dbGaP/NDAR certification form
(DOC) that should be submitted at the time the PI is ready to seek certification for data submission to a GWAS repository. Please also review
IRB Policy 45
(PDF) for more information.
In This Section...
IRB Adverse Event Forms
IRB Consent and Assent Forms
IRB HIPAA-Related Forms
IRB Initial Application Forms
IRB Patient Data Request Forms
IRB Renewal Application Forms
Other IRB Forms
Looking for a Researcher?
Area of Focus:
Aggressive Treatment of Juvenile Idiopathic Arthritis
Autism Spectrum Disorders
Behavioral / Mental Health
Chronic Conditions / Special Health Care Needs
Congenital Cardiac Surgery Outcomes
Continuous process improvement (CPI) and quality
Developmental Cognitive Neuroscience
Endocrinology / Metabolism
Environmental Exposures and Childhood Health Outcomes
Genetic Cardiovascular Disease
Genetics and Developmental Biology
Health Promotion and Disease Prevention
Host: Pathogen Interaction
Neuroscience / Neurodevelopment
Research Liver Regeneration
Science Education Outreach
Solid Organ Transplantation
Stem Cell Biology
Stem Cell Transplantation
Tissue Response to Injury
Ben Towne Center for Childhood Cancer Research
Center for Child Health, Behavior and Development
Center for Childhood Infections and Prematurity Research
Center for Clinical and Translational Research
Center for Developmental Biology and Regenerative Medicine
Center for Developmental Therapeutics
Center for Genetics and Development
Center for Global Infectious Disease Research
Center for Immunity and Immunotherapies
Center for Integrative Brain Research
Center for Tissue and Cell Sciences
Treuman Katz Center for Pediatric Bioethics
Upcoming Research Events
11th Annual Pediatric Bioethics Conference – The Delicate Triangle: Responsibilities and Challenges in the Provider-Patient-Parent Relationship
11th Annual Pediatric Bioethics Conference – The Delicate Triangle: Responsibilities and Challenges in the Provider-Patient-Parent Relationship (Day 2)