IRB Forms and Samples | Office of Research Compliance | SIU

Institutional Review Board Forms

When submitting an IRB application, make sure to include all necessary supporting documents. Examples of supporting documents include consent and recruitment forms, as well as any relevant study materials. Study materials should be submitted in a Word or PDF format. Additionally, be sure to include copies of any interventions and/or interview protocols. If you are conducting an electronic survey, please provide a test link. Note that approved electronic survey formats include SurveyMonkey and Qualtrics.

For information on how to obtain a SurveyMonkey License, please visit: https://oitkb.siu.edu/knowledge-base/create-a-survey-with-surveymonkey/

IRB Forms

• IRB Application (Downloadable PDF)
• IRB Application (Auto-downloaded Word Document)
• Form A - Signature Page PDF
• Form B-1 Key Personnel Table
• Annual Progress Report - Category II
• Extension Request Form - Category III
• Protocol Close-Out Form
• International Projects Application Addendum
• Modification Request Template

Institutional Review Board Samples

The IRB recommends using the samples and templates below to ensure compliance with human subjects research regulations. 

Sample Consent Forms

• Sample Consent Form for Interviews, Interventions, and Experimental Protocols
• Sample Online Survey Consent Form
• Sample Parent/Guardian/LAR Consent Form
• Sample Class Project Consent Form
  • For more information on class projects and when to use this consent form, see the IRB FAQs page. 

Other Samples

• Sample Assent Forms
• Sample Solicitation Email
• Sample Translation Verification Letter