IRB Intake Form Name * First Name Last Name Email * Phone (###) ### #### Preferred method of communication? Phone Email Text Name of Affiliation/Institution/Unaffiliated: * Position * Choose your best answer. Student Independent Researcher/Scholar Professor Community Researcher/Advocate Job Title: if not applicable, write N/A Are you ready to submit a research proposal to the IRB? Yes No Have you completed any research ethics training? * Yes No, I still need training If yes, which training did you receive? PHRP CITI Other Briefly describe your research topic or proposed project. * Only 2-4 sentences required Thank you, your intake form entry has been sent to the IRB committee chair for review. Your submission will be reviewed within 5-10 business days.
