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Download Form A (WIRB Eligibility Checklist)
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EMORY WIRB ELIGIBILITY New Protocol Submission to WIRB Study Information Sponsor Protocol Number: Study Title: Study Team Information PI Name: Coordinator Name: WIRB Eligibility Determination Please check your response to the following questions: 1. Is this research project involving human subjects designed to evaluate prospectively the safety and/or effectiveness of new drug(s) or device(s)? Continue to Question 2. YES NO 2. Does the study full into one of the following categories? a. Is this a Phase I Industry-Designed, Industry-Initiated and Industry-Sponsored multi-center drug or equivalent device research project? OR b. Is this a Phase II Industry-Designed, Industry-Initiated and Industry-Sponsored multi-center drug or equivalent device research project? OR c. Is this a Phase III Industry-Designed, Industry-Initiated and Industry-Sponsored drug or equivalent device research project? OR d. Is this a Phase IV Industry-Designed, Industry-Initiated and Industry-Sponsored drug or equivalent device research project? 3. Is this an Investigator-initiated study and/or does the Emory investigator hold the IND or IDE? YES Submit to eIRB for Emory IRB review. Continue to Question 3 NO Submit to eIRB for Emory IRB review. YES Submit to eIRB for Emory IRB review. Continue to Question 4 NO 4. Does any member of the research team have a financial interest in this research project? Yes (See COI website for definition and reporting requirements.) NO 5. Is the Atlanta VAMC or CHOA a participating site on this research project? YES Submit to eIRB for Emory IRB review. Continue to Question 5 Submit to eIRB for Emory IRB review. Continue to Question 6 NO 6. Is the proposed research project co-sponsored by a federal agency or non-profit organization? YES NO Submit to eIRB for Emory IRB review. Submit to WIRB Listserv for access to modified eIRB submission. **NOTE: The Emory IRB reserves the right to withhold any new research study from being sent to WIRB Form A WIRB Eligibility Checklist Last updated: September 27, 2016
