Rocky Mountain College Institutional Review Board (IRB) - Application for Exemption
Please fill out this form completely to initiate consideration of your request for Exempt status for your research proposal.

Be sure to submit all required documents* (as indicated in this form).

Note that you must also submit a certificate of completion of the National Institute of Health's Human Subjects Training:
<http://phrp.nihtraining.com/users/login.php.>

What is your name *
We will use the information you enter here to link your the content in this form to other applicaiton materials.
Your answer
What is your email address? *
Your answer
What is your project title? *
Your answer
Who is your faculty adviser on this project? This question is intended for student researchers only. Non-students, please enter "N/A". *
Please enter the first and last name of the professor with whom you are working with on this project. Note: We will make your IRB application infomation available to that professor.
Your answer
What exemption to 45 CFR Part 46 (Human Research Regulations) do you believe applies to your research. *
Please review exemptions to 45 CFR part 46 and then use the dropdown list to indicate which exemption is the best fit. Alternatively, use the list to indicate that you would like a full IRB review of your proposal. Use the decision charts in this link to help you make your choice: <http://www.hhs.gov/ohrp/policy/checklists/decisioncharts.html>
What is your research question(s)? *
Clearly state your research question and any subquestions.
Your answer
Who is the target population of your study? *
In paragraph form, please identify the individuals and groups who will be the subjects of your research.
Your answer
Will you use an informed consent document to inform the subjects of your study about the research project in which the subjects are participating? *
Have you submitted a sample of the informed consent form you will share with the subjects of your research? *
You MUST submit a sample of your informed consent form. Submit your informed consent form to: linda.eliason@rocky.edu
If you are not using an informed consent form, please explain why. *
Note: there are only a few exceptions to informed consent when working with live human subjects.
Your answer
What methods will you use to gather data from your target population? *
Choose all that apply
Required
What, if any, data collection instruments will you use to gather data from these subjects? *
E.g. audio recorders, pen and paper, video recording devices, software applications, medical devices.
Your answer
Explain what methods/ procedures will be used to minimize risk to/ ensure the anonymity of target population throughout the life of the project. *
Your answer
Have you submitted samples of all relevant data collection materials to the IRB board? *
For example, informed consent form, example test or survey questions, sample of interview guides, a description or example of the existing data you will be collecting. These materials MUST be submitted to Linda.eliason@rocky.edu in order for your application to the IRB to be reviewed.
Have you submitted a certificate of completion of the National Institute of Health (NIH) Human Subjects training to Linda.eliason@rocky.edu? *
Link to NIH training website: http://phrp.nihtraining.com/users/login.php.
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