Forms & Documentation, Institutional Review Board (IRB) | Griffin Hospital

130 Division St. | Derby, CT 06418 | (203) 735-7421

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IRB Forms & Documentation

Title	Modified Date	Size
COI (Conflict of Interest) Form	10/8/2012	51.50 KB	Download
HIPAA Research Authorization Form	10/8/2012	31.00 KB	Download
Informed Consent Checklist	10/8/2012	43.00 KB	Download
Informed Consent Guidelines	10/8/2012	102.50 KB	Download
Investigator Compensation Form	10/8/2012	19.50 KB	Download
IRB - HIPAA Waiver of Authorization Request Form	10/8/2012	28.00 KB	Download
Master List for New Protocol Submission	10/8/2012	28.50 KB	Download
Medical Records Department Policies and Procedures	10/8/2012	25.00 KB	Download
Medical Records Form	10/8/2012	24.00 KB	Download
PI Instruction Sheet	10/8/2012	41.50 KB	Download
PI's Attestation Form	10/8/2012	29.00 KB	Download
Protocol Face Sheet	10/8/2012	25.00 KB	Download
Protocol Guidelines	10/8/2012	23.00 KB	Download
Sample Informed Consent Form	10/8/2012	38.50 KB	Download
Waiver of HIPAA Research Authorization	10/8/2012	32.50 KB	Download
Waiver of Informed Consent	10/8/2012	39.50 KB	Download

Phone: (203) 732-1447

Susanne Salgado
IRB Coordinator, Institutional Review Board
(203) 732-1447
ssalgado@griffinhealth.org

Brian D. Karsif, MD, MPH, FACOG
Chairman, Institutional Review Board
(203) 640-9386
bkarsif@griffinhealth.org

Fax: (203) 732-6569

Griffin Hospital