Online Reliance Consultation Request Form
Describe the study or studies for which reliance on a Single IRB (sIRB) is requested:
A reliance request can cover a single study or a group of studies conducted by a certain investigator or institution/organization. If an ERICA application has been completed, please include the IRB number.
Provide the names of the sites (institutions and/or organizations) that are expected to be involved in this reliance request:
This should include all institutions and organizations that will need Reliance Consultation with the University of Utah Human Research Protection Program (HRPP).
What institution/organization would you like to serve as the single IRB (SIRB) for your study?
Indicate what stage/phase in the overall process the study or studies are currently:
Protocol development / Planning phase for a grant submission
Ready for IRB submission and review
Currently active protocol
Other - please specify below
Who is the sponsor/anticipated sponsor for this study or studies?
What are you requesting from the IRB at this point:
Just in time approval/letter of support
Information on the SIRB process
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Indicate who will be the lead investigator (and/or Utah-based participating investigator) for the study or studies under this reliance request:
The lead investigator may be the Utah-based investigator.
Provide the name and contact information for the individual(s) the University of Utah HRPP should contact to set up the Reliance Consultation meeting:
Note that an investigator involved in the study (or studies) must be included in the Reliance Consultation meeting.