Forms

IRB Submission Update

The CSU Channel Islands Institutional Review Board (IRB) is currently transitioning from a paper-based application process to the Cayuse Human Ethics electronic submission system.

Please note the following:

• Summer Review: IRB Committee members are off contract during the summer. As a result, IRB applications are not reviewed during this period. Review activities will resume at the beginning of the fall semester.

• Transition to Cayuse: To support this transition, the IRB is no longer accepting paper or email-based IRB applications.

• Cayuse Human Ethics: The Cayuse Human Ethics application will be available at the beginning of the fall semester. Additional information, training resources, and submission instructions will be posted on this website before the system becomes available.

Thank you for your patience and understanding as we make this transition. We are excited to introduce a more streamlined and user-friendly IRB submission process. If you have any questions or would like assistance planning your research timeline, please contact the IRB Office at irb@csuci.edu.

 

• Student IRB Application Form (MS Word, 56.4KB) (11/2021)
• Faculty/Staff IRB Application Form (MS Word, 56.8KB) (11/2021)
• Guidelines for Completing IRB Application (PDF, 83.2KB) (10/2016)
• Research Continuation Form(MS Word, 32KB)(4/2023)
• IRB Protocol Amendment Form (MS Word, 18.9KB)(4/2023)
• Closeout Form(MS Word, 31KB)(4/2018)
• Audio/Video Release Form(MS Word, 29.5KB)(10/2020)
• Photographic Release Form(MS Word, 28KB)
• Checklist of Required Recruitment Poster Elements (PDF, 53.4K) (11/2021)

NOTE: If you plan to conduct your study online, please be sure to revise the language of the applicable Consent Form templates accordingly.

Sample Forms and Templates

• Sample IRB Application Form (PDF, 108.6KB)

Consent Form Templates

• Adult Consent Form Template(MS Word, 28KB)
• Parent Guardian Consent Template (MS Word, 27KB) - Minors, (individuals less than 18 year of age) are not legally able to give consent for participation in research on their own behalf. Their parent(s) or legal guardian must provide consent before they can participate in research projects.

Assent Form Templates

In addition to obtaining parental/legal guardian consent, researchers should also obtain assent of children between the ages of 9 and 17. When a minor provides assent, it means they agree to take part in the research. Although they are too young to give informed consent, they may be old enough to understand the proposed research in general, its expected risks and possible benefits, and the activities expected of them as subjects.

• Adolescent Assent Template(MS Word, 21KB)-For use with the Parent Guardian Consent form for minors13 to 17 years old
• Child Assent Template(MS Word, 22KB)-For use with the Parent Guardian Consent form forminors 9 - 12 years old

Other Templates

• Project Information Form Template(MS Word, 24KB)
• Sample Site Authorization Letter(MS Word, 17.3KB)
• Sample Permission Letter from Institutional Management(MS Word, 23.5KB)