Single IRB (sIRB) Authorization Agreement
1) This form is to be used when two or more IRBs wish to rely on a single protocol (review) and researchers at both institutions are "engaged".  Refer to the definition of "engaged" in OHRP’s Guidance on Engagement of Institutions in Human Subjects Research (October 16, 2008). http://www.hhs.gov/ohrp/policy/engage08.html
2) After completing this form go directly to your email inbox and forward the submission confirmation with the required attachments to cphs@csumb.edu.  Your request cannot be processed without the attachments.
3) Questions? Contact cphs@csumb.edu, or (831) 582-5130.
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Email *
Lead Researcher's Name: *
Lead Researcher's Email Address: *
Lead Researcher's Phone Number: *
Include the area code.
CSUMB Researcher's Name (if different than lead researcher):
CSUMB Researcher's Email Address (if different than lead researcher):
Name of the External Institution or Agency: *
Provide the name of the collaborating institution (i.e.: university).
What is the external institution/agency's FWA? *
The CPHS cannot approve cooperative agreements without this. Refer to OHRP's FWA Lookup Tool: http://ohrp.cit.nih.gov/search/fwasearch.aspx?styp=bsc.
Administrative Contact Information for External IRB:
Provide a name and email and/or phone number.
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