Some forms are available in more than one format. Some of the PDF files below may be filled out electronically and saved using Adobe Acrobat Reader. (Note: Applications from external agencies are not necessarily fillable online, regardless of file type.)
| Title/Description | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Application To Use Live Vertebrate Animals | ACAP | (paper form no longer in use) | iacuc@med.unc.edu | IACUC |
| Tissue Harvest Application | ACAP | (paper form no longer in use) | iacuc@med.unc.edu | IACUC |
| Antibody Production Application | ACAP | (paper form no longer in use) | iacuc@med.unc.edu | IACUC |
| Breeding Only Application | ACAP | (paper form no longer in use) | iacuc@med.unc.edu | IACUC |
| Title/Description | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Amendment to Application: paper form for pre-ACAP *only* | ACAP | Note: go to ACAP to start an amendment: only pre-ACAP applications will be directed to the old paper form | iacuc@med.unc.edu | IACUC |
| Amendment to Application (Animal Numbers Only): paper form for pre-ACAP *only* | ACAP | Note: go to ACAP to start an amendment: only pre-ACAP applications will be directed to the old paper form | iacuc@med.unc.edu | IACUC |
| Amendment Guidelines | IACUC | Information from IACUC website: not a form | iacuc@med.unc.edu | IACUC |
| Title/Description | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Use of Radioactive Materials in Laboratory Animals |  |
n/a | iacuc@med.unc.edu | IACUC |
| Use of Biohazardous Materials in Laboratory Animals | |
n/a | iacuc@med.unc.edu | IACUC |
| Use of Chemical Hazards in Laboratory Animals | |
n/a | iacuc@med.unc.edu | IACUC |
| Title/Description | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Annual Review Form | ACAP | Annual review now done via ACAP. | iacuc@med.unc.edu | IACUC |
| Exception Form | ACAP | Exceptions now done via ACAP. | iacuc@med.unc.edu | IACUC |
| Title/Funding Change Form | ACAP | Title/funding change done via ACAP. | iacuc@med.unc.edu | IACUC |
| Personnel added to application | ACAP | Personnel added now done via ACAP as amendment. | iacuc@med.unc.edu | IACUC |
| Principal Investigator Transfer Form | ACAP | PI transfer now done via ACAP as amendment. | iacuc@med.unc.edu | IACUC |
| Satellite Animal Housing Form | ACAP | Satellite Animal Housing now done via ACAP. | iacuc@med.unc.edu | IACUC |
| Husbandry Duties Performed by Investigator |  |
n/a | iacuc@med.unc.edu | IACUC |
| Check Sheet for Investigator Health Monitoring | |
n/a | iacuc@med.unc.edu | IACUC |
Go to Event Registration to certify personnel online. Contact Training & Compliance at 6-5569 if any questions.
| Title/Description | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Carolina Postdoc Program for Faculty Diversity | or |
Guidelines | Rhonda Craig-Schwarz | VCRED |
| Title/Description | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Request for Investigational Drug Services (IDS) | |
IDS Policy | OCT | IDS |
| CTA Review Request Form | |
(for new clinical trial contracts only) | Sabrena Mervin-Blake | OCT |
| CDA Review Request Form | |
(for confidentiality agreements only) | Sabrena Mervin-Blake | OCT |
| Amendment Review Request Form | |
(for contract amendments only) | Sabrena Mervin-Blake | OCT |
| Review Request Form | |
Guidelines | Sabrena Mervin-Blake | OCT |
| Status Request Form | HTML | n/a | Sabrena Mervin-Blake | OCT |
| Title/Description | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Internal Budget Template |  |
Instructions | Sabrena Mervin-Blake | OCT |
| Lab Costs | |
n/a | Sabrena Mervin-Blake | OCT |
| Source Document Templates | HTML | n/a | Sabrena Mervin-Blake | OCT |
| Study Startup Checklist | |
n/a | Sabrena Mervin-Blake | OCT |
| Title/Description | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Financial Tool Kits | HTML | n/a | Sabrena Mervin-Blake | OCT |
| Name/Title | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Request for Cost-Sharing in External Funding | |
n/a | Jo Ann Gustafson | VCRED |
| Travel to Visit an Extramural Sponsor | |
n/a | VCRED | |
| University Research Council: Research Grant | or |
n/a | Jennifer Pruitt | VCRED |
| University Research Council: Publication Grant | or |
n/a | Jennifer Pruitt | VCRED |
Note: Some of these forms are print-only versions and will have to be downloaded as such and then converted for word processing software before they can be customized for UNC-Chapel Hill. If you need assistance converting a form to another software program, please consult your department's technical support staff or the ITS help desk.
Hard copies of application forms are available by contacting the individual funding agencies.
| Agency/Form Name | Format(s) | Notes |
|---|---|---|
| Grants.gov | varies | Download application packets from participating federal agencies. |
| American Cancer Society (ACS) | HTML | Many ACS proposals may be submitted via Proposal Central; other awards use forms available from the ACS website. |
| American Heart Association (AHA) | HTML | Mandatory electronic submission. |
| American Lung Association (ALA) | HTML | Submission through Proposal Central. |
| Centers for Disease Control (CDC) | HTML | n/a |
| Department of Education (DOED) | HTML | n/a |
| Department of Energy, Office of Science | HTML | n/a |
| National Endowment for the Arts (NEA) | HTML | n/a |
| National Endowment for the Humanities (NEH) | HTML | n/a |
| National Institutes of Health (NIH) ERA Commons Registration Form | HTML | n/a |
| NIH Research Training and Career Development Award Application | HTML | n/a |
| NIH Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) Grant Applications | HTML | n/a |
| NIH SBIR Phase I and II Contract Solicitation (PHS 2005-1) | HTML | n/a |
| NIH Forms and Applications | HTML | n/a |
| National Science Foundation (NSF) 04-23 Grant Proposal Guide | HTML | For proposals submitted before September 1, 2004, click here. |
| NSF forms | HTML | Proposals must be submitted using NSF Fastlane, the online submission system. |
| Public Health Service (PHS) General Forms | HTML | Under the Division of Health and Human Services, abbreviated DHHS or HHS. |
| PHS 398 (for NIH) | HTML | Public Health Service (PHS) application guidelines and forms. |
| PHS 416 (for NIH) | HTML | National Research Service Award (NRSA), PHS application guidelines and application forms. |
| PHS 310 (for NIH) | RTF | Human Subjects assurance form. |
| PHS 2590 (for NIH) | HTML | PHS Grant Continuation, sometimes called a renewal or a non-competing continuation. Also for Research Career Awards and Institutional National Research Service Awards. |
| PHS 5161-1 | or |
PHS Grant Application Information and Instructions for completion of Standard Form 424. Cover package for the SF424 forms kit. (Most federal government agencies accept these applications, except NIH and NSF, which have developed their own packages). |
Note: Forms on these pages may have been developed for use by researchers at other institutions and may contain information specific to that institution. Check all forms carefully.
| Title/Description | Format(s) | Notes | Questions? | Admin. Office |
|---|---|---|---|---|
| Application to use Human Embryonic Stem Cells in Research | |
Guidelines/Policies | Robert Lowman or Terry Magnuson | Office of the Associate Vice Chancellor for Research |
There are a variety of forms available, and their use depends on the nature of the study and where it is in its life cycle. People new to the IRB process might benefit from the Guide to the IRB Process.
See Submission Instructions for number of copies and where to send the application. See also meeting deadlines and schedules, important for studies that must be reviewed by the convened IRB ("full board" studies).
Forms may change without notice, and old forms will not be accepted after some period of time. You are strongly advised to go to this web page and download a current form each time you need to submit to the IRB.
Most forms are in Microsoft Word; some are Adobe Acrobat PDF.
| Forms | |
|---|---|
| Application for IRB Approval of Human Subjects Research (updated 29-Sep-2008) |
|
| Addendum for Multi-Site Studies Where UNC-CH is the Lead Coordinating Center | |
| Determination Whether Research or Similar Activities Require IRB Approval (see instructions on form for when to use this) (updated 30-Sep-2008) |
|
Templates for Standard Consent Documents (English documents revised 2-Oct-2007; Spanish, 7-Sep-2005, unless otherwise indicated) |
Biomedical |
Social Behavioral |
|---|---|---|
|
Consent to Participate in a Research Study Adult Subjects |
||
Parental Permission for a Minor Child to Participate in a
Research Study |
||
Assent to Participate in a Research Study Adolescent Subjects (15-17 yrs) |
||
Assent to Participate in a Research Study Minor Subjects (7-14 yrs--use for Biomed and Soc/Beh) |
||
Consent for Stored Specimens, Identified Consent for Stored Specimens, Unidentified (instructions for applications that include use of specimens) |
||
| Addendum to provide additional information to subject after original consent | ||
SSN Collection Forms 1. Use with subject to obtain permission to collect Social Security Number for payment 2. Use with subject to obtain permission to collect Social Security Number to use as an identifier (see SSN guidance for details) |
||
HIPAA Addendum to Consent Form |
||
HIPAA Authorization Template |
||
Alternatives to Full Consent Forms; Examples |
||
Short Consent Form (for a single subject who may be illiterate, blind, or otherwise unable to read the consent form — used when full consent form has to be read or translated for subject; updated 12-May-2008) |
||
Telephone Consent Script (example) |
|
|
Postal or Email Letter for Anonymous Questionnaire (example) |
|
|
Information or Fact Sheet (example) |
|
|
Focus Group (example) |
|
|
Important note for studies that were approved before March 15, 2005: If you used one of the initial application forms current before the formation of OHRE, these are usually grandfathered for renewals and modifications. However, if the IRB finds that the information on the old initial application form is inadequate, you may be requested to update to the new initial application form. Use the new (and brief) submission sheets below for modifications or renewals, but you may attach the existing approved description of the study (IRB application) and consent forms. Application and consent forms may be reformatted if the investigator prefers to use the new templates, but this is not required for previously approved studies. See the IRB Changes FAQ for additional information.
| Form | |
|---|---|
| Request for Renewal of IRB Approval or Study Closure (updated 8-Sep-2008) |
|
| Modification of Approved Human
Subjects Research (updated 29-Apr-2008) |
|
| Adverse Event |
|
| HIPAA-Related Forms for Access to Records at UNC-CH (not OHRE forms) | |
|---|---|
| UNC HCS Form HD974: Request for Access to PHI or Aggregate Data for Research Purposes (UNC Hospitals medical records) (updated 7-Feb-2006) |
|
| UNC School of Dentistry Request for Access to Protected Health Information (PHI) for Research Purposes |
|
| UNC School of Dentistry Guidelines for Release of Protected Health Information (PHI) for Research Purposes |
|
| Miscellaneous | |
| Responsibilities of Staff in Human Subjects Research |
|
| Statement of Compliance | |
| Report of Emergency Use of a Test Article to the IRB (updated 20-Feb-2008) | |
| Other UNC-CH Guidance and Forms (primarily links to other web sites) | |
|---|---|
| General Clinical Research Center (GCRC) Guidance and Forms | |
| Environment, Health and Safety | |
| Oncology Protocol Review Committee | |
| Investigational Drug Service (IDS) | |
| Conflict of Interest Policy | |
| Request to Conduct Research with UNC Hospitals Staff | (coming soon) |
| Title/Description | Format(s) | Notes | Policy/Questions | Admin. Office |
|---|---|---|---|---|
| Internal Proposal Processing Form (IPF) | Electronic Form | See Instructions and/or Frequently Asked Questions below. | Web form technical questions: Andrew Reynolds | Policy questions: Hamilton Brown | OSR |
| IPF Help page | HTML | IPF Instructions | n/a | OSR |
| IPF FAQ | HTML | Frequently Asked Questions | n/a | OSR |
| IPF Question List | |
Provides a hard copy of all the questions asked on the IPF. | n/a | OSR |
| Modular (Mod) Budget Justification | |
Modular Budgets only | Hamilton Brown | OSR |
| On-Campus Mod Budget Template | |
Modular Budget template, On-Campus only | Hamilton Brown | OSR |
| Off-Campus Mod Budget Template A | |
Modular Budget template, Off-Campus only | Hamilton Brown | OSR |
| Off-Campus Mod Budget Template B | |
Modular Budget template, Off-Campus within 10 miles only | Hamilton Brown | OSR |
| OSR Upload tool | ONYEN/SOMID required | Allows users to upload completed Grants.gov application package(s) to OSR or SPO for review. | Important: Please notify the appropriate OSR/SPO contract specialist after your application has been uploaded. | OSR |
| Sample Proposal Cover Page | |
Example if no prescribed form exists. | John Gallagher | OSR |
| Sample Subcontractor Commitment Letter (incoming) | |
Example of the information required for incoming subcontract | Hamilton Brown | OSR |
| Sample Subcontractor Commitment Letter (outgoing) | |
Example of the information required for outgoing subcontract | Hamilton Brown | |
| Human Subjects Certification Data Sheet | or
|
Required with IPF when appropriate. | n/a | OSR |
| Project Financial Guarantee Form | HTML | Used to request account number prior to institutional acceptance of an award. |
Michele Shoffner | OSR |
| Title/Description | Format(s) | Notes | Policy/Questions | Admin. Office |
|---|---|---|---|---|
| Cover Sheet Prime/Sub Budget Revision |
or |
n/a | n/a | OSR |
| Budget Revision | or |
n/a | n/a | OSR |
| Prime/Sub Account Budget Revision | or |
n/a | n/a | OSR |
| Title/Description | Format(s) | Notes | Policy/Questions | Admin. Office |
|---|---|---|---|---|
| Cost Accounting Standards (CAS) Exemption Request | HTML | Used to charge costs normally treated as F&A, as Direct | Post Award Services | OSR |
| F&A Rate Reduction Request: Form 1 |
|
Used when sponsor is a for-profit company. (see F&A Policy) | John Gallagher | OSR |
| F&A Rate Reduction Request: Form 2 | |
Used for all other sponsors (see F&A Policy) | John Gallagher | OSR |
| Title/Description | Format(s) | Notes | Policy/Questions | Admin. Office |
|---|---|---|---|---|
| Application for Advancement of C&G Funds | |
Used to request an advance of Contracts & Grants Funds (see Guidelines) | OSR Policy 11A / Post Award Services | OSR |
| Application for Purchase of Computers | |
Used to request approval for computer purchase | DDD memo on Direct vs. F&A charges to Sponsored Agreements |
OSR |
| Equipment Assignment | |
Off site equipment assignment | Post Award Services | OSR |
| Final Invention and Certification Form | |
Post Award Services | OSR | |
| Notice of Termination (NOTR) |
|
n/a | n/a | OSR |
| Account Adjustment Request (AJ1) | |
Instructions included with the form. | Post Award Services | OSR |
| Letter of Justification: Changing Investigator's Percent Effort | |
Instructions included with the form. | n/a | OSR |
| Institutional Prior Approval System (IPAS) |
or |
Instructions included with the form. | n/a | OSR |
| Documentation of Non Personnel Cost Sharing | |
Used to document expenditures towards the fulfillment of cost sharing commitments. | PARS Coordinator | OSR |
| PHS 3734 | |
Official Statement Relinquishing Interests and Rights in a Public Health Service Research Grant | Kelly Musty | OSR |
| Travel Coordinator Certification Program |
or |
n/a | n/a | OSR |
| Title/Description | Format(s) | Notes | Policy/Questions? | Admin. Office |
|---|---|---|---|---|
| Service Center Oversight (Flowchart) | |
Flowchart to determine fee oversight authority. | OSR Policy 13 and OSR Procedure 15 / Kevin Maynor or Chun Ae Lee | OSR |
| Research Service Center Policy | HTML | n/a | ||
| Research Service Center Procedure | HTML | n/a | ||
| Service Center Business Plan | |
n/a | ||
| Rate Development Worksheet | |
n/a |