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Disclaimer: The list of forms is not all-inclusive. Additional forms will be added as the site grows.

Proposal Forms

Proposal Samples:

Financial Management

Compliance Forms:

Material Transfer Agreement (MTA) Forms

Animal Care & Use Forms

Templates:

Conflict of Interest

IRB Human Subjects Forms

IRB Templates:


Biological Safety Forms

The Institutional Biosafety Committee (IBC) protocol submission forms have been updated as of November, 2010.

Form I is submitted for ALL research. Include all appropriate forms along with Form I.

Disclaimer: The list of forms is not all-inclusive. Additional forms will be added as the site grows.

Proposal Forms

Proposal Samples:

Financial Management

Compliance Forms


Compliance Samples:

Material Transfer Agreement (MTA) Forms

Animal Care & Use Forms

IRB Human Subjects Forms

IRB Templates:

IU Simon Cancer Center Scientific Review Committee (SRC) Documents:

VA Research Documents:

Biological Safety Forms

IBC Recombinant DNA Forms:


IBC Safety Procedures Information Sheets:

Radiation Safety Forms

pdf A-1 Form - Radionuclide Use Permit Application

All individuals requesting a Radionuclide Use Permit for non-human use must complete this form in its entirety. Please use the Guidance document below to assist in completing the A-1 application.

The A-1a form below has the same intent as the A-1 form but must be completed for human-use research.

doc A-1a Form - Application to Use Radioactive Materials in Humans for Research Purposes (Rev. Mar. 2011) doc A-1b Form - Application for Human Use Research Involving Machine Produced Radiation (Rev. Mar. 2011)

doc A-2 Form - Radionuclide Use Permit Amendment (Rev. Oct. 2013)

doc A-3 Form - Authorization to Use Radioactive Materials (Rev. October 2013)

doc A-3x Form - Authorization to Use X-ray Equipment For Non-human Use (Rev. July 2009)

doc A-3xb Form - Radiation Safety Training for Fluoroscopic Non-Human Research (Non-Operator)

pdf A-4 Form - Application for Radionuclide Laboratory Approval (Rev. October 2013)

doc A-5 Form - Request for Personnel Monitoring Service (Rev. June 2013)

   A-6 Form - Radionuclide Use Permit Progress Report

doc A-7 Form - Notice of Pregnancy (Rev. Oct. 2013)

   A-8 Form - Radionuclide Use Permit

doc A-9 Form - Waste Pickup Request Form (Rev. Feb. 2014)

   A-10 Form - Precautions for Animals Containing Radioactive Materials

   A-10a Form - Precautions for Animals Containing PET Radiopharmaceuticals

doc A-11 Form - Contamination Survey for Animal Care Facilities (Rev. Aug. 1998)

doc A-12 Form - Log Sheet for Animal Bedding Contaminated with Radioactive Materials (Rev. Dec. 1998)

pdf A-13 Form - Employee Status Change (Rev. Aug. 2013)
A-13 E-Form Submit A-13 Form electronically via the website

doc A-14 Form - Radiation Survey Data Sheet (Rev. July 2007)

pdf A-16 Form - Request for Decommission of Lab(s) (Rev. October 2013)
A-16 E-Form Submit A-16 Form electronically via the website

pdf A-17 Form - Cancellation of Radionuclide Use Permit (Rev. October 2013)

doc Iodination Check List

doc Radionuclide Inventory Record

doc Recyclable Container Survey Form