Forms - Human Research Protection Program

Office Hours:
Monday - Friday,
8am - 5pm

Mailing Address:
Michigan State University, 202 Olds Hall
East Lansing, MI 48824.

Phone: (517) 355-2180
Fax: (517) 432-4503
Email: irb@msu.edu

Office Location:
202 Olds Hall.
Olds Hall is located between the Administration Building and MSU Main Library. Campus Map

			File Format
	Name of Form	Description	Word	PDF
	Request for Document Copy Form	Read form description	Open Word	Open PDF
	Initial Application Reference Form	Read form description	Open Word	Open PDF
	Renewal Application Reference Form	Read form description		Open PDF
	Fifth Year Appendix Form	Read form description	Open Word	Open PDF
	Revision Application Reference Form	Read form description		Open PDF
	Closure Form	Read form description	Open Word	Open PDF
	Unanticipated Problems (Non-Clinical) Form	Read form description	Open Word	Open PDF
	Unanticipated Problems (Clinical) Form	Read form description	Open Word	Open PDF
	Certification for the Use of Deidentified Human Cell Line	Read form description	Open Word	Open PDF
	Certification for the Use of Deidentified Human Tissue	Read form description	Open Word	Open PDF
	Certification for the Use of Public Use Data File	Read form description	Open Word	Open PDF
	Registering a Database as an Approved Public Data File	Read form description	Open Word	Open PDF
HIPAA Forms
	HIPAA Instructions - MSU Research Privacy Board Template	Read form description	Open Word	Open PDF
	HIPAA Authorization Form – MSU Research Privacy Board Template	Read form description	Open Word	Open PDF
	HIPAA Authorization Form – Sparrow Hospital Template	Read form description	Open Word	Open PDF
	HIPAA Authorization Form – Ingham Hospital Template	Read form description	Open Word	Open PDF
	HIPAA Data Use Agreement – MSU Template	Read form description	Open Word	Open PDF

Please note that applications for initial review, renewal, or revision must be submitted through the MSU IRBs Online Application System.

Consent templates and instructions for completing the forms below can be found on the Form Instructions page.

**Please download forms by clicking on the appropriate download format link below. Forms should be downloaded each time they are used, as they are subject to change.

Note: You will need Acrobat Reader to view the PDF forms .