Texas Woman's University Institutional Review Board

Texas Woman's University Institutional Review Board

Request to Initiate Institutional Authorization Agreement (IAA)

An IAA is a written agreement prescribed by OHRP that describes the obligations of both parties when one relies on the other for IRB review and continuing oversight of one or more human subject research projects. IAAs must be approved by the signatory officials of each institution. In order to request that the TWU rely on another institutional IRB review and approval for a specific study, an investigator must complete this form, obtain necessary signatures, and forward the signed form to the Office of Research & Sponsored Programs at . Detailed information regarding the IAA process can be found in the IRB Procedures.

TWU Principal Investigator (PI) Information:
Name of PI: / Phone:
Status: faculty student staff other : / E-mail:
Department:
Colleague ID# (this is the 7-digit # on your ID):
If the PI is a student, provide the following information for the faculty advisor:
Name of Advisor: / E-mail:
TWU Department:
Project Information:
Title of Study:
Estimated beginning date of study: / Estimated duration of study
Campus (Denton, Dallas, or Houston) / Select OneDentonDallasHouston / Level of review: exempt expedited full
Type of Project : thesis professional paper dissertation class project
(check all that apply) faculty research pilot other
Reviewing IRB Information (if needed, contact the Office of Research for assistance):
Name of the IRB Reviewing the Protocol:
Federalwide Assurance # of IRB:
Contact Person for IRB (provide name and email or phone #):
Name & title of PI on other IRB application:

Other Information:

IRB Approval Date:

Explain the TWU investigator’s role on the project and relationship or affiliation with the other institution.

Explain whether or not any part of the subject recruitment and data collection will be done on the TWU campus. Typically, IAAs are only used when the study is being conducted at a non-TWU site.

List the TWU research team members other than PI and advisor (attach additional pages as needed):

Name
TWU 7-digit Colleague ID # (if applicable)
Email Address:
TWU Department
Role on Project
Name
TWU 7-digit Colleague ID # (if applicable)
Email Address:
TWU Department
Role on Project

Attachments (as applicable):

Attached / N/A
Approval letter from other institution’s IRB (required)
Protocol
Consent form
Current training certificate for TWU investigator if a current certificate is not already on file with the IRB
Current training certificate for other TWU research team members if a current training certificate is not already on file with the TWU IRB
Other ()
Other ()

Provide the IRB with any other information necessary for the review of this study.

Signatures (Approvals):

TWU Principal Investigator (PI): Signature certifies that the investigator has primary responsibility for all aspects of the research project.
______/ ______
Principal Investigator / Date
TWU Faculty Research Advisor (for student research only): Signature certifies that the faculty member has read, reviewed, and approved the content of the application and is responsible for the supervision of this research study.
______/ ______
Faculty Research Advisor / Date
TWU Academic Administrator: Signature certifies that the administrator has read, reviewed, and approved the content of the application.
______/ ______
Academic Administrator (Department Chair, Program Director, or Associate Dean) / Date

August 20171

Once the above signatures have been obtained, forward the signed form with applicable attachments to the Office of Research & Sponsored Programs (ORSP) via email to . The staff in ORSP will acknowledge the receipt of the request and begin working with the TWU PI and the other institution to facilitate the IAA.

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Office of Research & Sponsored Programs:

IRB Chair: Signature indicates agreement that an IAA is appropriate for this study and defers review and approval of this study to the IRB named on the cover page.
______/ ______
IRB Chair / Date
Office of Research & Sponsored Programs (ORSP): Signature indicates that ORSP is in agreement with the IRB chair and agrees that an IAA is appropriate for this study.
______/ ______
Director of Operations, Office of Research & Sponsored Programs / Date

August 20171