UIW Population Access for Research Request

UIW Population Access for Research Request
Researchers not affiliated with UIW, who would like to access the UIW community to conduct their IRB-approved research, must complete this form.

Submission of this form is NOT permission to conduct your study with the UIW community.

This request will be reviewed. If you are approved to conduct your study with the UIW community, you will receive a signed approval letter sent to the PI's email address provided in this form.

Approval from the UIW HRPP office does not grant permission from any program director, department chair, or dean to contact directly or solicit responses from their students, staff, or faculty. Please seek the appropriate departmental approval before directly soliciting participation.



The PI information listed in the form must match the information provided in the protocol.

UIW may deny any submission for any reason. Notification of denied access will be sent to the PI's email provided in this form.



For questions, please contact IRB@uiwtx.edu.
PI Name*

PrefixFirst NameLast Name
PI Institution*
PI Address*

Street Address

Street Address Line 2

CityState

Zip Code
PI Email*
example@example.com
PI Phone Number*
Please enter a valid phone number.
Select all applicable descriptions of the UIW Population you would like to access.*

Student/TraineeFacultyAdministrator/StaffExecutive Leadership
Select all applicable Schools/Colleges form which you would like to recruit:*

University-wide recruitmentCollege of Humanities, Arts, and Social SciencesDreeben School of EducationFeik School of PharmacyHEB School of Business and AdministrationIla Faye Miller School of Nursing and Health ProfessionsRosenberg School of OptometrySchool of Mathematics, Science, and EngineeringSchool of Media and DesignSchool of Osteopathic MedicineSchool of Physical TherapySchool of Professional StudiesOther: Please specify in the the question below
Explain for what purpose you wish to contact the above-selected population:*
e.g., I would like to recruit all UIW Health Professions Students for a focus group; I would like to advertise my research study with the following inclusion/exclusion criteria...to participate in a study conducted at XYZ Institution; I would like to send a survey to all UIW SOM Faculty.
IRB's FWA#
IRB Approval Number*
IRB Study Title*
IRB Review Category*

ExemptExpeditedFull Board
IRB Approval Letter*

Cancelof
Approved IRB Protocol*

Cancelof
Approved Consent Form/Information Sheet *

Exempt Protocols should include the information sheet
Cancelof
Please verify that you are human*
Should be Empty:

UIW Population Access for Research Request

Researchers not affiliated with UIW, who would like to access the UIW community to conduct their IRB-approved research, must complete this form.