IRB Approved of Unaffiliated Research Protocols
For use of this form, see UNCA IRB SOP-021 External Researchers
External Researchers Seeking toConductResearch amongUNC Asheville Students,Staff, and/or Faculty:
Approval to solicit involvement ofUniversity of North Carolina at Asheville(UNCA) students,staff, and/or faculty inresearchconducted byexternalresearchers must be obtainedfromtheUNCAIRBpriortorecruitment.Approval decisionsaremadeon a case-by-case basis, butthe researcherMUSTprovide a compelling justification forusingUNCAstudents, staff, and/or faculty as studyparticipantsand/or demonstratesomedirectbenefit tothecampuscommunity.In orderfor theUNCAIRB to considersuch arequest, theexternalresearchersmust (a) have IRB approval for thestudyfrom their home institution, (b)haveproof of training (i.e., CITI training certificate), (c)completethisExternalResearcher Authorization Agreement,and(e)submittheapproved IRBapplication fromtheirhomeinstitution.
I.External Researcher(s) Information:
a. / Name of research project:b. / Principal Investigator:
c. / PI’s Institution:
d. / Institution from which IRB was received:
IRB Registration #:
Federalwide Assurance (FWA)#, if any:
e. / Sponsor or Funding Agency:
Award Number, if any:
II.UNCAHuman Subjects:
Provide therequestedinformation below withas much detail as possible. Although this information mightalso bedescribedintheUNCAIRB application documents,itmustalso be addressed here.
a.Describe thespecificcharacteristics of the sample of UNCAstudents,staff, and/or facultysoughtforthestudy:
b.Specifically describe howUNCAsubjectswill be usedinthestudy:
c.Specifically describe howUNCAsubjectswill be recruited forthestudy:
d.Specificenddate forthe researchinvolvingUNCA subjects:
III.Certification
TheOfficialfromthePI’shomeinstitution signing belowacknowledgesthattheprotocol listed underSection I.above has been reviewedandapproved by your IRB andagreesthatUNCAmay rely on your IRBfor reviewandcontinuing oversight ofthe humansubjectsdescribedin theapprovedapplicationlisted under SectionI. above.TheIRBatyourinstitutionwillfollowwrittenproceduresforreportingfindingsandactionstoappropriateofficialsUNCA.
Thissigned documentmustbeaddedtotheapproved IRBapplicationatthePI’shomeinstitutionandsubmittedwiththeUNCAIRBapplication,anditmust be providedto OHRPupon request.
PI’s Signature
Print Full Name / DateInstitutional Title:
Signature of Signatory Official at PI’s Home Institution
Print Full Name / DateInstitutional Title:
Email:
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Tobe signed by theUNCA IRB Chairperson oncethe UNCA IRB Application for the External Researcher(s)has beenapproved.
Thisdocumentservesas a “Letter of Permission” toconducttheresearch asoutlinedwithintheapprovedUNCAIRBapplication.
SignatureofUNCAIRBChairperson:
Print Full Name / Date