Templates&Forms - UTHealth

Templates & Forms

Frequently-requested consent templates and institutional forms used in Human Subjects research are available online for your convenience.

CONSENT / ASSENT Templates
Adolescent Assent - English Informed Consent - English Informed Consent - English (HIPAA) DNA Consent – Mandatory Language Biological Sample Retention – Mandatory Language	Adolescent Assent - Spanish Informed Consent - Spanish Informed Consent - Spanish (HIPAA)

Other Helpful TOOLS / FORMS
Department Review Quality Improvement Guidance Conflict of Interest Certification	IRB Registration Statement Guest Account Information

STUDY MANAGEMENT Tools
Protocol Template (simple) Protocol Template (complex) Study Delegation Log Protocol Deviation Log	Data Safety Monitoring PLAN (DSMP) Checklist Data Safety Monitoring BOARD (DSMB) Charter Template Adverse Event Log

For IRB MEMBERS
IRB Reviewer Checklist	Advertisement Checklist

CPHS HELPLINE 713-500-7943
iRIS HELPLINE 713-500-7960
UTHealth’s Compliance Hotline (1-888-472-9868)

Committee for the Protection of Human Subjects
6410 Fannin, Suite 1100
Houston, Texas 77030

Phone 713.500.7943
Fax 713.500.7951
Email cphs@uth.tmc.edu

IRIS Support 713.500.7960