Forms for new and ongoing research projects

If you are unable to access any of the forms, please contact the IRB office at 901.516.2323.

For New Project Submissions:

• New Investigator Profile (PDF) (required)
• Investigator Responsibilities (PDF) (required meeting with MHIRB Administration)
• Study Summary (PDF) 
• Consent Template (PDF) (for At-risk Studies)
• One-Time Emergency Use of Test Article Application (PDF) 
• Exemption Certification (PDF) 
• Disclosure and Description of Financial Interests Related to Sponsored Research (PDF) 
• Medical Record Request (PDF) 
• Tissue ICF template (PDF) (for Tissue/Blood Studies)
• Rare or Genetic Specimen Research Procurement Process (PDF) 
• Tumor Registry Research/Special Request Form

For Ongoing Projects:

• Revision/Amendment for Research Project Form (PDF)
• Consent Template (PDF)
• Adverse Event Report (PDF)
• Safety Reports (PDF) 
• Project Review/Closure form (PDF)

Submission Flow Charts

• "IRB Jurisdiction Determination for Research at Le Bonheur Children's Medical Center"   
  Before submitting a research study to either the Methodist Healthcare IRB or UTHSC IRB, please review the attached flow chart to decide which IRB has jurisdiction. 
• "Le Bonheur Research Study Submission Process"
  If a study involves Le Bonheur inpatients at the Dunlap or Germantown locations and will be going to the UTHSC IRB, see the attached flow chart for details of the process.
• "Path to Contracting"
  To determine whether UT research administration or Methodist Healthcare Foundation negotiates the contract see the attached flow chart.