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  • Human Subjects Division - Documents
    higher though we recommend use of the most recent version You may receive messages from Adobe to upgrade For Mac users be sure to open the form in Adobe Reader or Acrobat APPLICATION Determination Exempt Status PDF Purpose The Exempt Status Request has been converted to PDF and combined with portions of the guidance document The purpose of this form is to provide the UW Human Subjects Division staff with the necessary information to determine if a research activity involving human subjects may be eligible for a determination of exempt status as allowable by the regulations that govern human subjects protections The Word version of this document is linked below Related Documents APPLICATION Determination Exempt Status Word SOP Exempt Determination Change Notes Related to Ver 2 80 noted 05 30 2014 09 57am Added Exempt 7 Use this version going forward sherrye Related to Ver 2 70 noted 11 01 2013 02 20pm Updated instructions Okay to use previous version sherrye Related to Ver 2 60 noted 10 19 2013 04 39pm Updated name to new naming convention on website sherrye Related to Ver 2 60 noted 06 28 2013 11 55am Updated to align with new SOP Please use latest version of this form sherrye Related to Ver 2 50 noted 05 31 2013 09 45am Updated mailing address information Okay to use previous version sherrye Related to Ver 2 40 noted 04 26 2013 11 41am The title and position fields have been separated in the contact information section Okay to use previous version sherrye Related to Ver 2 30 noted 01 25 2013 09 09am Updated FCOI language Okay to use previous version sherrye Related to Ver 2 20 noted 11 30 2012 08 46am Instructional text added to Category 4 Existing Data Okay to use previous

    Original URL path: http://www.washington.edu/research/hsd/docs/1254 (2014-06-24)
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  • Human Subjects Division - Documents
    05 30 2014 Version 2 80 Filesize 328 KB Audiences Researcher Doc Type Form APPLICATION Determination Exempt Status Word Purpose The purpose of this form is to provide the UW Human Subjects Division staff with the necessary information to determine if a research activity involving human subjects may be eligible for a determination of exempt status as allowable by the regulations that govern human subjects protections The link to the PDF version of this form with embedded guidance is located below Related Documents APPLICATION Determination Exempt Status PDF SOP Exempt Determination Change Notes Related to Ver 2 80 noted 05 30 2014 09 59am Added Exempt 7 Use this version going forward sherrye Related to Ver 2 70 noted 11 01 2013 02 21pm Updated title Okay to use previous version sherrye Related to Ver 2 60 noted 10 19 2013 04 39pm Updated name to new naming convention on website sherrye Related to Ver 2 60 noted 06 28 2013 11 54am Updated to align with new SOP Please use latest version of this form sherrye Related to Ver 2 50 noted 05 31 2013 09 43am Updated mailing address information Okay to use previous version sherrye Related to Ver 2 40 noted 04 26 2013 11 39am Separated position and title fields in contact information section Okay to use previous version sherrye Related to Ver 2 30 noted 01 25 2013 09 05am Update to FCOI language Okay to use previous version sherrye Related to Ver 2 20 noted 11 30 2012 08 44am Updates made to PDF version Okay to use previous version until 12 31 2012 sherrye Related to Ver 2 10 noted 06 22 2012 08 41am Removed line from Chair signature assurance that stated I certify that this research has received an intramural review

    Original URL path: http://www.washington.edu/research/hsd/docs/1207 (2014-06-24)
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  • Human Subjects Division - Documents
    Videos Training Options to Meet Requirements Verification Report Browse A Z Forms Policies Procedures and Guidance Topics Glossary Contact HSD Contact HSD Directions to HSD Documents Document Update Schedule HSD posts updated documents to the web site on the last Friday of each month In rare cases due to an urgent need an updated document will be posted during the month HSD and the IRB ask that researchers make every effort to use the most recent document version Questions about a specific document version Contact hsdforms uw edu Document Details Download Document 1293 Last Updated 10 19 2013 Version 1 00 Filesize 1 82 MB Audiences Research Participant Researcher Doc Type Form Use of HSD PDF Forms HSD Forms are compatible with Adobe Reader Version 10 and higher though we recommend use of the most recent version You may receive messages from Adobe to upgrade For Mac users be sure to open the form in Adobe Reader or Acrobat APPLICATION Join an IRB Purpose Thank you for your interest in joining the UW Human Subjects Division Institutional Review Board IRB Being an IRB member provides an excellent opportunity to oversee the ethical conduct of human research and to gain insight

    Original URL path: http://www.washington.edu/research/hsd/docs/1293 (2014-06-24)
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  • Human Subjects Division - Documents
    database or repository and the use or disclosure of Public Health Information PHI from a database or repository for research is subject to oversight by the Institutional Review Board IRB to ensure compliance with relevant HIPAA privacy rules Oversight may include review and approval of a protocol specifying the conditions under which data and specimens may be collected and shared The IRB may also assess whether adequate provisions are being taken to protect the privacy of subjects and maintain the confidentiality of repository specimens and data To learn more about HIPAA Privacy rule related to research repositories see Research Repositories Databases and the HIPAA Privacy Rule Change Notes Related to Ver 3 10 noted 05 12 2014 10 14am Updates to engagement section Please use this version going forward sherrye Related to Ver 3 00 noted 02 28 2014 10 29am Added reference to Genetic Supplement removed genetic questions from this form Please use this version going forward sherrye Related to Ver 2 90 noted 01 31 2014 10 19am Updates to the research staff information section new section on non UW institutions removed training section added directional to DOD and DOJ supplements when funding from these federal entities are included Please use this version going forward sherrye Related to Ver 2 80 noted 10 19 2013 04 41pm Updated name to new naming convention on website sherrye Related to Ver 2 80 noted 08 09 2013 10 29am Updated HSD information box and information regarding translated consent materials Please use latest version sherrye Related to Ver 2 70 noted 05 31 2013 09 47am Updated mailing address information Okay to use previous version sherrye Related to Ver 2 60 noted 01 25 2013 09 22am Updated FCOI language Okay to use previous version sherrye Related to Ver 2 50

    Original URL path: http://www.washington.edu/research/hsd/docs/463 (2014-06-24)
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  • Human Subjects Division - Documents
    edu Document Details Download Document 1343 Last Updated 05 12 2014 Version 3 00 Filesize 538 KB Audiences HSD Staff IRB Member Researcher Doc Type Form APPLICATION Specimen or Data Use Identifiable Word Use for Medical Records Review Purpose To gather the necessary information for the review of identifiable data and or specimens of human subjects The form is limited to researchers who are not directly interacting with people but who are reviewing identifiable private information about individuals and or analyzing identifiable specimens Examples medical records protected health information PHI employment data study records pathology specimens data and or specimens from a repository NOTE This is the Word version of this form Related Documents APPLICATION Specimen or Data Use Identifiable PDF Use for Medical Records Review Use of Identifiable Biological Specimens Data Guidance Change Notes Related to Ver 3 00 noted 05 12 2014 10 13am Updates to engagement section Please use this version going forward sherrye Related to Ver 2 90 noted 02 28 2014 10 28am Added reference to new Genetic Supplement sherrye Related to Ver 2 80 noted 01 31 2014 10 24am Updates to the research staff information section new section on non UW institutions removed training section added directional to DOD and DOJ supplements when funding from these federal entities are included Please use this version going forward sherrye Related to Ver 2 70 noted 12 10 2013 10 12am Title change to web page sherrye Related to Ver 2 70 noted 11 22 2013 11 43am Added reference to FERPA and PPRA Please use this version going forward sherrye Related to Ver 2 60 noted 10 19 2013 04 43pm Updated name to new naming convention on website sherrye Related to Ver 2 60 noted 08 09 2013 10 31am Updated HSD information box

    Original URL path: http://www.washington.edu/research/hsd/docs/1343 (2014-06-24)
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  • Human Subjects Division - Documents
    the IRB ask that researchers make every effort to use the most recent document version Questions about a specific document version Contact hsdforms uw edu Document Details Download Document 295 Last Updated 01 31 2014 Version 5 70 Filesize 272 5 KB Audiences Researcher Doc Type Form APPLICATION Specimen or Data Use Non Identifiable and self determination Purpose The purpose of this form is to determine whether human subjects are involved in research that consists of obtaining private information data and or biological specimens according to federal state and University of Washington definitions If not the project requires neither determination of exempt status nor IRB review Use this form only if your research does not involve direct contact with human subjects for research purposes Related Documents SOP Human Subjects Research Use of Non Identifiable Biological Specimens Data Guidance Change Notes Related to Ver 5 70 noted 01 31 2014 09 22am Removed reference to SOP on Public Data sets and section to add co investigators Please use this version going forward sherrye Related to Ver 5 60 noted 11 01 2013 01 14pm Reordered and updated question 4 A 1 Okay to use previous version sherrye Related to Ver 5 50 noted 10 19 2013 04 44pm Updated name to new naming convention on website sherrye Related to Ver 5 50 noted 06 28 2013 11 45am Updated form to align with new SOPs Please use latest version sherrye Related to Ver 5 40 noted 05 31 2013 09 54am Updated mailing address information Okay to use previous version sherrye Related to Ver 5 30 noted 02 22 2013 09 57am Updated directional in section A to clarify when to complete the questions regarding coded data Okay to use previous version sherrye Related to Ver 5 20 noted 01 27

    Original URL path: http://www.washington.edu/research/hsd/docs/295 (2014-06-24)
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  • Human Subjects Division - Documents
    here HSD Home Browse A Z Documents 1675 HSD Home Training Training HSD Training Videos Training Options to Meet Requirements Verification Report Browse A Z Forms Policies Procedures and Guidance Topics Glossary Contact HSD Contact HSD Directions to HSD Documents Document Update Schedule HSD posts updated documents to the web site on the last Friday of each month In rare cases due to an urgent need an updated document will be posted during the month HSD and the IRB ask that researchers make every effort to use the most recent document version Questions about a specific document version Contact hsdforms uw edu Document Details Download Document 1675 Last Updated 10 19 2013 Version 1 00 Filesize 2 24 MB Audiences HSD Staff IRB Member Doc Type Form Use of HSD PDF Forms HSD Forms are compatible with Adobe Reader Version 10 and higher though we recommend use of the most recent version You may receive messages from Adobe to upgrade For Mac users be sure to open the form in Adobe Reader or Acrobat CHECKLIST Approval Purpose This required Checklist is used by the IRB to ensure and document that it has considered all applicable criteria for approval during the

    Original URL path: http://www.washington.edu/research/hsd/docs/1675 (2014-06-24)
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  • Human Subjects Division - Documents
    Options to Meet Requirements Verification Report Browse A Z Forms Policies Procedures and Guidance Topics Glossary Contact HSD Contact HSD Directions to HSD Documents Related Topics Department of Defense DoD Research Training Requirements Department of Defense DoD Requirements Document Update Schedule HSD posts updated documents to the web site on the last Friday of each month In rare cases due to an urgent need an updated document will be posted during the month HSD and the IRB ask that researchers make every effort to use the most recent document version Questions about a specific document version Contact hsdforms uw edu Document Details Download Document 918 Last Updated 01 31 2014 Version 3 00 Filesize 2 19 MB Audiences HSD Staff IRB Member Doc Type Form Use of HSD PDF Forms HSD Forms are compatible with Adobe Reader Version 10 and higher though we recommend use of the most recent version You may receive messages from Adobe to upgrade For Mac users be sure to open the form in Adobe Reader or Acrobat CHECKLIST Department of Defense DOD Purpose This checklist is used by the IRB to document that Department of Defense DOD requirements are met prior to approving DOD supported

    Original URL path: http://www.washington.edu/research/hsd/docs/918 (2014-06-24)
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