IRB RELIANCE AGREEMENT REQUEST FORM UVA IRB-HSR to serve as IRB of RecordIrb Reliance Agreement • September 1st, 2023
INSTRUCTIONS AND INFORMATION: Relying Sites should only complete this request form AFTER the UVA IRB-HSR has approved the study locally. One form is to be completed for EACH institution that agrees to rely on the IRB-HSR. Submit the following documents to the Relying site for completion: IRB Reliance Agreement Request Form UVA IRB-HSR to serve as IRB of Record (complete UVA study information) Current approved IRB-HSR protocol, consent(s)/assent(s) (if applicable) Relying Site Local Context Template (Appendix A) -used to add local context to the UVA IRB approved consent/assent documents (TRACK CHANGES MUST BE TURNED ON) Submit the following documents to the UVA IRB to add a relying site Completed IRB Reliance Agreement Request Form UVA IRB-HSR to serve as IRB of Record Completed Modification Request form Tracked copy of the consent/assent which includes the relying site LOCAL CONTEXT information included. NOTE: See Page 6 for complete list of potential documents to be submitted t
IRB Reliance Agreement Request for Chamberlain University IRB to Serve as the Relying IRBIrb Reliance Agreement • September 24th, 2021
Relying IRB’s IRB Registration number and Federal Wide Assurance number (if any): IRB00011037/ IORG0008174 and Federal wide Assurance (FWA) #FWA00021986
IRB Reliance Agreement (Reviewing IRB)Irb Reliance Agreement • March 8th, 2023
This Agreement applies to all Scholarship of Teaching and Learning (SoTL) human subject research conducted by Relying Institution for which Relying Institution submits an application under the “Broad SoTL Protocol” at the Reviewing Institution. This Agreement is effective upon the date of last signature and will remain effective for five (5) years at which time the Agreement may be renewed by both parties.
IRB Reliance Agreement ApplicationIrb Reliance Agreement • June 7th, 2017
Protocol Title: Principal Investigator: PI’s affiliation: Faculty StaffOther Brown Graduate/Medical StudentAdvisor’s name: Will Brown relinquish IRB oversight? Yes No Is Brown conducting human subject research activity?as defined in 45 CFR 46.102 (d) and (f) Yes No Name of Funding Source and Institute Proposal Number:(if research is externally funded) if none,write: n/a Funding Proposal Title: (if applicable) Does Brown issue a sub-award?Yes No If yes, to: Does Brown receive a sub-award?Yes No If yes, from:
IRB Reliance Agreements (RA): Fred Hutch Relies on a Single IRB (sIRB)Irb Reliance Agreement • February 20th, 2020
IRB Reliance Agreement with Doha Institute for Graduate Studies (DI) GuidelinesIrb Reliance Agreement • November 8th, 2021
The objective of this agreement is to streamline the IRB approval process for QU and DI researchers whenever they undertake a collaborative human subject research endeavor requiring an IRB approval. This agreement will facilitate efficiency and encourage collaborative and cooperative research activities between the two Institutions
The Christ Hospital (TCH) IRB Reliance Agreement Application Protocol Title and NumberIrb Reliance Agreement • November 6th, 2019
ContractIrb Reliance Agreement • February 5th, 2019
The Officials signing below agree that (Institution B) may rely on the designated IRB for review and continuing oversight of its human subjects research described below: (check one)
Institutional Review Board (IRB) Reliance Agreement when CMU is the Reviewing Institution Use this form when CMU IRB provides review of a single research project involving human subjects for one or more other institutions. A separate Agreement must be...Irb Reliance Agreement • May 26th, 2020
The Responsible Officials signing below agree that Relying Institution may rely on the CENTRAL MICHIGAN UNIVERSITY IRB for review and continuing oversight of the human subjects research described below:
IRB Reliance Agreements (Inter-Institutional Agreements)Irb Reliance Agreement • December 15th, 2017
The Reliance Agreement, also called an Inter-Institutional Agreement (IIA), is a document signed by two institutions that are engaged in human participant research authorizing one of the institutions to serve as the reviewing IRB (IRB of Record). In multi-site research, the Reliance Agreement permits a single IRB to review human participant research activities for more than one site.
IRB Reliance Agreement ApplicationIrb Reliance Agreement • May 8th, 2017
Name of Other Institution: Protocol Title: Principal Investigator: Signatory Official: Name: Title: IRB Contact: Name: Address: Phone: Email: Is this institution a “Smart IRB” member?Yes NoSMART IRB is an initiative developed under an award from the National Center for Advancing Translational Sciences (“NCATS”) of the National Institutes of Health (“NIH”) to support single Institutional Review Board (“IRB”) review in facilitation of multi-site human subjects research. Other Institution’sFWA#: Other Institution’sIRB Registration #: Name of Funding Agency:(if research is funded) if none, write: n/a Funding Title: (if applicable)
FORM: IRB Reliance AgreementIrb Reliance Agreement • August 8th, 2023
Appendix A: Sample Accelerating and Value Added Resources (AVARs) for the Alpha Stem Cell Clinic NetworkIrb Reliance Agreement • March 1st, 2016
The following is a partial list of accelerating and value added resources developed by the Alpha Stem Cell Clinic Network. These AVARs may be developed or scaled to support the goal of accelerating stem cell clinical trials.
Instructions for Requesting an IRB Reliance AgreementIrb Reliance Agreement • April 3rd, 2019
An IRB reliance agreement (formerly known as an IRB authorization agreement) is an agreement between two entities allowing the IRB of one entity to assume regulatory oversight of research activities conducted at the other entity for a single or multiple research studies. When an IRB assumes regulatory oversight for another entity, it is referred to as the designated or single IRB. The entity accepting this IRB’s oversight is referred to as the reliant entity or site.
Study Team routes Independent IRB application and finalized contract to IRO for vetting.3Irb Reliance Agreement • February 20th, 2020
SOP 2.1.4 Reliance AgreementsIrb Reliance Agreement • November 28th, 2017
GMU researchers may sometimes be engaged in non-exempt human subjects research that involves co- investigators and/or human subjects at other institutions. In accordance with 45CFR46.114, GMU may rely on the review of another qualified IRB or allow another institution to rely on the GMU IRB. This is done through an IRB Reliance Agreement (also referred to as an IRB Authorization Agreement). The scope of the agreement is usually limited to a specific protocol and on a case-by-case basis.
UCLA Reliance on Other UC IRBs, UCLA CTSI IRBs and BeyondIrb Reliance Agreement • November 8th, 2012
▪ By mutual or collective written agreement, one or several IRBs agree to rely on the IRB review of one or several other IRBs.
IRB Reliance AgreementIrb Reliance Agreement • January 9th, 2020
This IRB Reliance Agreement is required when an external institution relies on the SUNY Downstate IRB for review and oversight of human research. For instructions for obtaining an FWA and designating the SUNY Downstate IRB on the FWA, see https://www.hhs.gov/ohrp/register-irbs-and-obtain-fwas/fwas/file-a-new-fwa/index.html
DEFINITIONSIrb Reliance Agreement • February 22nd, 2020
Authorized Institutional Official Delayed Onset Research Engaged in Research Federalwide Assurance (FWA) IRB of Record
Carolinas Collaborative Projects IRB Reliance Agreement Guidance (SOP)Irb Reliance Agreement • June 21st, 2017
The members of the Carolinas Collaborative (CC) have agreed to rely on each of the other institutions’ IRB(s) to review collaborative projects. This master agreement is limited to research conducted as part of the CC and concerns the IRB review of studies involving the sharing of data among the collaborating institutions. Research involving prospective enrollment for interventions or other direct participation of human subjects is not covered by this agreement. The IRB reliance and cooperative IRB review allows the CC institutions to cooperate in research studies, while avoiding duplication of effort with respect to IRB reviews.
IRB Reliance Agreement Between Texas A&M University-Corpus Christi And Institution NameIrb Reliance Agreement • June 17th, 2021 • Texas
THIS IRB RELIANCE AGREEMENT (“Agreement”) is between Texas A&M University-Corpus Christi, a member of The Texas A&M University System, an agency of the State of Texas, having a place of business at 6300 Ocean Drive, Corpus Christi, Texas, hereinafter referred to as (“TAMU-CC”) and Institution Name, having a place of business at address, hereinafter referred to as (“IRB of Record”), each of the aforementioned being referred to individually as the (“Party”) or collectively as the (“Parties”).
Relying Institution: Name of Institution Relying on the Designated IRBIrb Reliance Agreement • September 20th, 2019
The Officials signing below agree that may rely on the designated IRB for review and continuing oversight of its human subject research described below:
