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Local Review Reporting Form
When the University of Utah IRB (UU IRB) acts as the Single IRB for Multi-Site Research

Local review is a study-specific review that needs to occur at the local site.  This includes verification that the site-specfic information is incorporated appropriately for the site in the protocol and consent documents. It also includes the relying site HRPP’s review responsibilities as outlined in the reliance agreement; this generally includes confirmation of COI, training/qualifications of local research staff, ancillary reviews, etc.

If you have concerns or COI management plans to provide the UU IRB, please complete and submit this online form. If you have no concerns or management plans to provide, you are not required to complete this form.

  • UU IRB Number
    The UU IRB Number is provided in the reliance request letter that was sent to you.
  • Name of your site, which is relying on the UU IRB
  • Name of the PI at your site
  • Name and contact information of the person completing this form
  • Describe local review concerns or items.
    This may include the following items:
    • Financial conflict of interest management plans for any investigators or study staff at your site.
    • Institutional conflict of interest management plans for your site.
    • Concerns about sufficient resources, training, or non-compliance relevant to this study being conducted at your site.
    • Concerns raised during ancillary reviews that are performed at your site.
    • Local laws or policies that are not addressed in the protocol or consent document.
  • Attach applicable documents.
    This may include the following:
    • Conflict of interest management plans
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The UU IRB will require amended study materials if the study is not compliant for your site. You are under no obligation to allow the study to be conducted at your site, even if UU IRB approval is granted for your site.

If you have any questions about completing this form, please contact the UU IRB at 801-581-3655 or We are happy to assist you.

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