ࡱ> cfb bjbj11 4DSS C @@LtaG    x)x)x)FFFFFFF$CIKGx))^x)x)x)G@@  G:+:+:+x)(@R  F:+x)F:+:+6B<"E P&Ti)DCF1G0aG`CwL)wL8EE8wL@Ex)x):+x)x)x)x)x)GG:+x)x)x)aGx)x)x)x)wLx)x)x)x)x)x)x)x)x) :  LLU INSTITUTIONAL REVIEW BOARD Applicant Checklist for IRB Review- SBCUSD Research Protection Programs (RPP) 24887 Taylor Street, Suite 202 Loma Linda, CA 92350 (909) 558-4531 (voice) / (909) 558-0131 (fax) / e-mail: irb@llu.edu  This checklist is for use only in submitting an IRB application for research conducted with the San Bernardino City Unified School District (SBCUSD). RPP will confirm that the following requirements are submitted appropriately at time of receipt. GUIDE TO ASSEMBLY OF APPLICATION PACKETAdministrative (Expedited or Exempt) Review: Submit this checklist with one original (hardcopy) set of the bulleted items described, as applicable.Organize packet in the following sequence: IRB Application Form Informed Consent Document HIPAA Authorization for Use of Protected Health Information Appendices (Include recruitment materials, questionnaires, and any other supporting documentation) Completed San Bernardino City Unified School District (SBCUSD) Request to Conduct Research Packet SBCUSD Response to Request to Conduct Research Form, if available.GUIDE TO ADDITIONAL REQUIREMENTS PI Confirmed or NA A/Is the request approved by SBCUSD?  FORMCHECKBOX  Yes: Attach copy of SBCUSDs Response to Request to Conduct Research Form  FORMCHECKBOX  Pending Will the conduct of the study depend on services from or collaboration with non-LLUAHSC or non-SBCUSD institution(s)?  FORMCHECKBOX  Yes: Letter of agreement is attached or contract is in progress.  FORMCHECKBOX  No Are other applicable or professional services required?  FORMCHECKBOX  Yes: Attach letters of support  FORMCHECKBOX  No  RESEARCH CONFLICT OF INTEREST Go to  HYPERLINK "http://www.llu.edu/assets/research-affairs/docs/research-coi-training-access-guide.pdf" http://www.llu.edu/assets/research-affairs/docs/research-coi-training-access-guide.pdf for instructions and links to the conflict of interest training and disclosure system. Disclosure does not need to be completed before the IRB submission.GRANT/CONTRACT If the study is sponsored by an external agency/institution, has a proposal or agreement been processed with Research Affairs?  FORMCHECKBOX  Yes: Provide LLeRA # _________________.  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