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Human Subjects Division (HSD)

Documents

Document Details

Last Updated 07/07/2014
Version 2.90
Filesize 2.49 MB
Audiences Researcher
Doc Type Form
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APPLICATION: Determination, Exempt Status (PDF)

Purpose

The Exempt Status Request has been converted to PDF and combined with portions of the guidance document.

The purpose of this form is to provide the UW Human Subjects Division staff with the necessary information to determine if a research activity involving human subjects may be eligible for a determination of “exempt” status, as allowable by the regulations that govern human subjects protections.

The Word version of this document is linked below.

Change Notes

  • Related to Ver. 2.90, noted 07/07/2014 @ 10:55am
    Clarifying updates that go along with new exempt category 7. Please use this version going forward.
    - sherrye
  • Related to Ver. 2.80, noted 05/30/2014 @ 09:57am
    Added Exempt 7. Use this version going forward.
    - sherrye
  • Related to Ver. 2.70, noted 11/01/2013 @ 02:20pm
    Updated instructions. Okay to use previous version.
    - sherrye
  • Related to Ver. 2.60, noted 10/19/2013 @ 04:39pm
    Updated name to new naming convention on website.
    - sherrye
  • Related to Ver. 2.60, noted 06/28/2013 @ 11:55am
    Updated to align with new SOP. Please use latest version of this form.
    - sherrye
  • Related to Ver. 2.50, noted 05/31/2013 @ 09:45am
    Updated mailing address information. Okay to use previous version.
    - sherrye
  • Related to Ver. 2.40, noted 04/26/2013 @ 11:41am
    The title and position fields have been separated in the contact information section. Okay to use previous version.
    - sherrye
  • Related to Ver. 2.30, noted 01/25/2013 @ 09:09am
    Updated FCOI language. Okay to use previous version.
    - sherrye
  • Related to Ver. 2.20, noted 11/30/2012 @ 08:46am
    Instructional text added to Category 4: Existing Data. Okay to use previous version until 12/31/2012.
    - sherrye
  • Related to Ver. 2.10, noted 06/22/2012 @ 08:42am
    Removed line from Chair signature assurance that stated: I certify that this research has received an intramural review and approval of scientific merit, if it did not go through an extramural review process.
    - sherrye
  • Related to Ver. 2.00, noted 05/25/2012 @ 09:07am
    New questions added for Lead Researcher. Do not use older versions of this form. HSD will not accept older versions after July 1, 2012.
    - sherrye
  • Related to Ver. 1.50, noted 01/27/2012 @ 08:47am
    Updated signature policy, okay to use previous version.
    - sherrye
  • Related to Ver. 1.30, noted 11/30/2011 @ 04:03pm
    Addition of the term survey to the guidance within the form.
    - sherrye
  • Related to Ver. 1.20, noted 05/27/2011 @ 09:54am
    Addition of double-sided copies instructions.
    - sherrye
  • Related to Ver. 1.10, noted 05/06/2011 @ 01:08pm
    Form is no longer in beta-test. Updated to force open guidance sections to close before printing.
    - sherrye
  • Related to Ver. 1.00, noted 03/23/2011 @ 09:14am
    Document newly added.
    - sherrye