Forms

WSIRB Forms 

As of January 15, 2019, WSIRB will be moving to an electronic submission system. Email submissions of applications will no longer be accepted after January 15.  Most of the Appendix G process, however, will remain outside the new system. Researchers requesting State Agency Data will still need to submit an Appendix G form to the appropriate Agency Data Manager.  The links below will redirect to the IRBManager system, with the exception of the Additional Signature Page for a Confidentiality Agreement, and a Request for Waiver of WSIRB Review Service Fees. Both those documents remain unchanged and can be downloaded and submitted via email. The Definitions and Instructions pages still contain important information for researchers, but have been updated to reflect the new electronic submission system. There is no longer a separate Appendices page on the WSIRB website.

The WSIRB implemented charges for its review services beginning December 1, 2015. Review will not be conducted unless charges are paid in full in advance. Additional information and a fee schedule are available at the WSIRB Fees link on the left

WSIRB will still confirm all received submissions. 

Before you begin submission through the IRBManager, please review the Researcher User’s Manual.

Once you begin a form in IRBManager, it must be submitted within 90 days.  All forms are automatically deleted from the system if not submitted within that time.

Downloads and Links

• Click here to access IRBManager for Research Applications, Exempt Determination Requests and Associated Documents
  • Instructions for using the new IRBManager system
  • Note for Study Amendment Requests: Variable names for DOH Birth and Death Records have changed in early 2017. Contact the DOH Data Manager for more information before submitting the SAR to WSIRB.
• Appendices

  • Most Appendices will now function as internal documents within the new IRBManager system and do not need to be submitted separately. The link to the WSIRB Consent form template and HIPAA Authorization Template remain for reference only. Conflict of Interest reporting (Appendix N) is also still required of all study staff.

  • The Appendix G and H process has not changed. Researchers requesting state agency data and state agency resources will still need to download an Appendix G and/or Appendix H form and submit to the appropriate data manager listed in the Contact List below.

  •  Consent Form Template | HIPAA Authorization Template

  • Appendix G: State Agency Records Request (Rev. July 2016) | Contact List (April 2024)

  • Appendix H: Resource Requests (Dec 2018)

  • Appendix N: Conflict of Interest Reporting (Dec 2018)

  • Appendix N: Conflict of Interest Reporting for DSHS Employees Only (Dec 2018)

• Data Security Exhibit - Example
• Additional Signature Page - Confidentiality Agreement (Revised December 2023)
• Certification that Research Records Have Been De-Identified (Revised February 2018)
• Request Waiver of WSIRB Review Service Fees (Revised March 2018)

WSIRB Notes

• The WSIRB only reviews research within its jurisdiction: the HRRS and WSIRB only review research that falls within their authority or scope of review, including Washington State agencies: DCYF, DOH, DOC, DSHS, HCA, L&I, and OFM and, under formal agreement, with local government agencies, including for example: Clark County Public Health, Tacoma-Pierce County Health Department, and Whatcom County Health.