UW Research

Forms and Templates

*IRB Protocol, No Contact with Subjects


This form is used in conjunction with Zipline to submit an application to the IRB. Use the No Contact form only if you will have no interaction of any kind (in person, email, internet, social media, etc.) with your subjects.

Use the APPLICATION IRB Protocol if you will interact with subjects, such as with a web based-survey, telephone interview, focus groups, blood draw, etc.

The form must be submitted as a Word document (not PDF or other format).

Change Notes

Revise data sharing question for clarity and to add advisory point about UW Medicine security review for machine learning using UW Medicine PHI – 06.29.2023
Remove taxonomy emphasis for all references – 06.01.2023
Revision in response to NIH DMS policy; remove mandatory reporting question; other minor changes – 11.30.2022
Remove cannabis question; update to records retention requirements for subject identifiers; typo fixes and other minor organizational updates – 08.04.2022
Update references to revised consent materials; add cannabis research question – 10.08.2021
Add information about what constitutes the UW Covered Entity – 08.26.2021
Minor revision to question about prisoner subjects – 04.29.2021
Removed question regarding ITHS COVID review – 02.25.2021
Restructure COVID review question – 10.16.2020
Remove “Zipline” from document title and from documents referenced within; other, minor wording updates to several questions – 06.26.2020
Updated link to SUPPLEMENT Multi-Site or Collaborative Research – 01.31.2020
Updated instructions and clarifications about how to fill out the form for multi-site and collaborative study designs; revised PHI question to get more detailed information about how it is accessed; updates to formatting, typos, links, and remove references to Zipline pages that are renamed. – 11.15.2019
Removed all references to Confidentiality Agreements and to state law RCW 42.48 – 07.28.2019
Instructions about accessibility issues; new set of questions about return of individual research results; remove questions (newborn blood spots; retrospective/prospective data); minor wording, link and numbering corrections – 04.12.2019
Updated consent questions to conform with revised Common Rule; other minor fixes and updates – 11.30.2018
Many minor updates related to Zipline upgrade see release notes for details – 08.24.2018
Minor revisions to clarify the intent of various questions – 01.12.2018
Corrected typos – 06.23.2017
Corrected formatting – 04.14.2017
Updated links and fixed numbering typos – 04.05.17