ORRC USE ONLY: Sub #
/ Institutional Review Board (IRB)

Office of Regulatory & Research Compliance

MSC 309 - (Phone) 437-3850 (Fax) 437-3855

http://www.albany.edu/orrc/

COLLABORATING INDIVIDUAL EXTERNAL (NON-UALBANY) INVESTIGATOR

REQUEST FORM

Version 11.01.13

Please provide name, name of home institution, role in study, and CITI training completion information for each collaborating external investigator(s) who will be involved in your project.

A collaborating external investigator is:

1.  not affiliated with the University at Albany and

2.  affiliated with an institution that may not have its own IRB to review the study

3.  is not acting as an employee of any institution with respect to his or her involvement in the research being conducted by the University at Albany

If you are unsure or need assistance, do not hesitate to contact staff in the Office of Regulatory & Research Compliance. Please attach addition sheet, if needed.

NAME / NAME OF HOME INSTITUTION / ROLE IN PROTOCOL
Examples: collecting data, interviewing subjects, analyzing
data / CITI TRAINING
COMPLETION DATE*

* Mandatory Human Subjects Research Training must be completed by all individuals listed in protocol. A copy of the CITI Human Subject Training Report must be attached for each individual listed in protocol

The following documents are available for the collaborating independent investigators to review:

1.  Belmont Report

2.  DHHS/NIH/OHRP Human Subject Regulations, 45 CFR Part 46

3.  The University at Albany Federal Wide Assurance (FWA. To obtain a copy of the University’s FWA00001970, please contact ORRC Director, Adrienne D. Bonilla at or 518-437-3850.

An Individual Investigator Agreement must be completed and filed for each external investigator listed. The Agreement allows the University at Albany to extend its Federalwide Assurance to the collaborative human subjects research activities of an external investigator.

NOTE: Approval of external individual investigator is granted at the discretion of the University at Albany and is subject to campus, RF, and SUNY policies.

The Agreement is on the ORRC website at: Individual (External) Investigator Agreement