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Online Reliance Consultation Request Form

  1. 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.



  2. Provide the names of the 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).



  3. Provide the name(s) of the institution(s) and/or organization(s) recommended to provide Single IRB (sIRB) services under this reliance request:


  4. 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.



  5. 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.

 

* Required