The Center for Discovery

Institutional Review Board Request for Review of Research Involving Human Participants Proposal Form

(please review the complete pdf application before starting a new electronic application as you will not be able to save your work – an application must be completed in one sitting)

NIH https://phrp.nihtraining.com/users/login.php CITI https://www.citiprogram.org/

Respond to each of the items below by providing brief, but complete information under the designated heading. Identify any additional supporting documents in your response and attach them at the end of the form. See the CFD-IRB Manual Section V for Specific instructions and elaborations. All investigators must sign the Investigator Assurance at the end of this form.


Research Questions:

Rationale for Study:

Describe the participants for whom, or about whom, data are to be gathered.

Design and Study:

Outcomes of Study:
Outcomes of research studies may be of limited scope or have contributions for participants, generalized knowledge and/or methodological/technical advances with commercial implications. Respond to each of questions below in this regard

Risks and Minimization of Risk:

Informed Consent:

Confidentiality and Security of Data: