RELIANCE AGREEMENT REQUEST FORM MetroHealth IRB to serve as IRB of Record/Single IRB (V. 03-18-24)Reliance Agreement • March 19th, 2024
Contract Type FiledMarch 19th, 2024INSTRUCTIONS AND INFORMATION for INITIAL SUBMISSION: Relying Sites should only complete this request form AFTER the MetroHealth IRB has approved the study locally. One form is to be completed for EACH institution that agrees to rely on the MetroHealth IRB. Submit the following documents to the Relying site for completion: Reliance Agreement Request Form MetroHealth IRB to serve as IRB of Record/Single IRB (complete Metro study information 1st)-includes Relying Site Local Context Template (Appendix A) -used to add local context to the MetroHealth IRB approved consent/assent documents (TRACK CHANGES MUST BE TURNED ON) Current approved IRB protocol, consent(s)/assent(s) (if applicable) Submit the following documents to the METROHEALTH IRB to add a relying site via eIRB: Completed Reliance Agreement Request Form METROHEALTH IRB to serve as IRB of Record/Single IRB Tracked copy of the consent/assent which includes the relying site LOCAL CONTEXT information included. If applicable, copy