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WSIRB Forms

Researchers planning to submit a proposal to the WSIRB should call and discuss their proposed research with Review Section staff before preparing their application. You may call the Review Section staff at (360)902-8075.

Downloads and Links

• Research Application (Form revised November 2006)

• Exempt Determination Request (Revised August 2007)

• NEW: Exempt Request: Social Work Student Projects (March 2008)

• Continuation Approval Request (Revised October 2007)

• Study Amendment Request (Revised August 2007)

• Unanticipated Problem and/or Adverse Events (Revised August 2007)

• Additional Signature Page - Confidentiality Agreement (Revised July 2004 )

• Certification that Research Records Have Been De-Identified (April 2006)

If you have any difficulties downloading the electronic documents, please contact us at wsirb@dshs.wa.gov .

Researchers submitting proposals to the WSIRB should Review the following documents:

• Washington State Agency Policy on Protection of Human Research Subjects

• HIPAA Privacy Rule - Requirements For Research

To minimize problems opening PDF documents, we suggest that you always use the latest version of the Adobe Acrobat Reader.

For more ways to get in touch with the Department of Social and Health Services, go to the DSHS Contact Information Web page. Technical Site Comments: DSHS Webmaster. Copyright 2004 Washington State Department of Social and Health Services.