Forms and Templates

HSIRB has move to HRA Building,
1640 Marengo Street

Biomedical Consent, HIPAA Authorization, + More

Consent Templates

    1. Industry Sponsor, Cooperative Group, or External IRB
      The IRB accepts all industry sponsored consent forms with minimal change in formatting. Industry consent forms need to only be modified to include the addition of USC specific requirements, such as local contact information, cost/injury payment language and removal of HIPAA. To facilitate review, submit an electronic version of the industry consent form and the version containing all USC specific modifications with all industry sponsored iStar submissions.
    2. HSIRB Informed Consent Template  8/30/2018
      Used when there is no consent form from an industry sponsor or cooperative group.
      Includes the essential elements of consent, instructions for use, the California Subjects Bill of Rights, conflict of interest requirements, considerations for long term specimen use and other institutional requirements.
    3. Information Sheet for Exempt Non-Medical Research
    4. Child Assent Template

Drafting a Consent Form

Short Form Consent Templates

Amharic Arabic
Armenian Cambodian
Chinese Dari
English Farsi
French Greek
Hebrew Hindi
Indonesian Japanese
Korean Romanian
Russian Spanish
Tagalog Thai
Vietnamese __


HIPAA Research Authorization

HIPAA for education/case studies

See also

IRB Application Forms

Protocol Template for an Investigator Initiated Study
NIH Budget Form
Experimental Subject’s Bill of Rights
IRB Authorization Agreement-Long Form
Research Consultant Non Engagement Agreement
Individual Investigator Agreement
Required Documents for Research with Other Sites
Research Advisory Panel of California
California requires proposed research projects involving certain opioid, stimulant, and hallucinogenic drugs classified as Schedule I and Schedule II controlled substances to be pre-reviewed and authorized by the Research Advisory Panel of California in the Attorney General’s Office.

Example/Model Study Applications for Health Sciences IRB

Full Board

Ancillary Committees

Clinical Trials Unit Forms
USC Institutional Biosafety Committee Forms
Radiation Safety Committee Application Forms

LAC+USC Healthcare Network Forms

Lab Utilization Worksheet

Investigator Initiated Studies(Drug or Device)

Sponsor Investigator Agreement