Saint Xavier University R

Institutional Review Board

IRB Forms

The IRB Application form may be downloaded in Word format from this page. When asked if you want to open or save the file, select "Save" and use your last name as the initial file name.

This form should be completed and submitted according the IRB's new submission instructions. Please read these instructions carefully to ensure proper submission and timely processing of your application.

SXU-IRB Application Checklist

  1. Did you email the IRB Chair of your intent to submit a proposal for IRB review (this triggers Canvas enrollment of Faculty researcher)?
  2. Does the project require any collaborators in outside institutions (other researchers, school teachers, principals?) If other collaborators are involved, has this project already been approved at the outside institutions? If so, please provide a signed letter from a gatekeeper(s) at this institution(s) at the time you submit your application materials.
  3. Is general statement of the problem clearly stated? Do you provide research questions?
  4. Do you provide a detailed description of the overall plan, procedures and methods?
  5. Have you attached any questionnaires, interview protocols and/or testing instruments? If required copyright, please include permission letter from authors/publishers.
  6. Have you attached a cover letter to participants with the formal consent and permission letter to parents?
  7. Have you described a number, relevant characteristics and source of participants? Describe how the participants will be recruited. If relevant, specify institutional ethical procedures, at the site of data collection, to which application will be subjected (i.e., what are the research review procedures at the institution where the data will be obtained; or how will you account for some students' inclusion but not others?)
  8. Have you described how the anonymity of participants is protected and what is the procedure to access these data? What will be specifically culled from the data set? Provide a detailed description of all efforts to guard the confidentiality of participants (especially in the case of minors/ students in school settings) by keeping collected data in a secure place.
  9. If relevant, specify any special participants populations (i.e., minors, prisons, or the mentally incompetent) involved in this project and describe the procedures for obtaining the appropriate consent. Participants may be considered 'special populations' when there is a question whether they are able to freely give consent to are coerced in giving consent.
  10. Will the participant(s) be exposed to any psychological intervention such as deception, contrived social situations, manipulation of the participants' attitudes, opinions, or self-esteem, psychotherapeutic procedures, or other psychological influences? If so, describe procedures for follow-up and/or debriefing.
  11. Have you discussed the status and qualifications of research assistants, if any?
  12. Make certain that all research personnel have current (less than 3 years old) NIH or CITI certification. Submit copies of the certificates at the time of application. Certification is required. No research proposal will be approved without proper documentation NIH or CITI certification.
  13. Have you indicated expected starting and ending dates for the project? Projects cannot begin without written approval of the IRB. DO NOT INCLUDE DATES ALREADY PAST!
  14. Have you outlined potential benefit of this project to the individual participant, group of participants or society in general?
  15. Have you discussed potential risks to participants and the measures taken to minimize such risks?
  16. Have justifications for any waivers of or alterations to the informed consent process been provided and justified on the basis of the criteria noted in Section F of the IRB Application Form (DOC)?