WIRB Application Guidance

Understanding the WIRB Application




Site

How to respond to the WIRB application question "What type of facility is this site?"

Site # of Site Forms Required
What type of facility is this site? (boxes to check)
What resources are available at this site to treat emergencies resulting from study related procedures? (boxes to check)
University of Wisconsin Hospital and Clinics
One for the entire 600 Highland Ave address location
  • University
  • Hospital
  • Medical Office
  • BLS trained personnel
  • ACLS trained personnel...
  • Emergency drugs and supplies...
  • Emergency response team...
  • Call 911
American Family Children's Hospital
One for the entire 1675 Highland Ave address location
  • University
  • Hospital
  • Medical Office
  • BLS trained personnel
  • ACLS trained personnel...
  • Emergency drugs and supplies...
  • Emergency response team...
  • Call 911
Medical Clinic-East, West of 1 S. Park
Separate site form for each clinic address
  • University
  • Medical Office
  • BLS trained personnel
  • ACLS trained personnel...
  • Emergency drugs and supplies...
  • Emergency response team...
  • Call 911
*Other Medical Clinic
Separate site form for each clinic address
  • University
  • Medical Office
Contact the center to determine emergency capabilities
WIMR
One site form for entire location
  • University
  • Research Clinic
Contact the center to determine emergency capabilities
*Research Only Location (no standard of care is offered to the patient in that location)
One for each address used
  • University
  • Research Clinic
Contact the center to determine emergency capabilities

*If the University is renting space for your research and uses the name University of Wisconsin (UW) in the location name this location falls under the University of Wisconsin-Madison purview for facility reporting purposes.  It will be necessary for you to determine which type of facility you are renting.  There may be unique aspects to your facility which might modify the type of facility boxes checked.  If you are unsure about your facility status contact the Commercial IRB Specialist for guidance.

How do I respond to the question, “Does this site have an obligation to use another IRB?”  Respond by checking the box for “No.”

How do I get distances answers?  Use Google.com or Mapquest.com to assist you.


State Law Question

Question: "Have the laws governing research in your state/province changed in the past year?"
Answer: "No"
An update will be sent via the ListServ and our web page will be updated if this answer changes.


How to fill out the CTA section

When filling out the WIRB application the following should be followed for the CTA section:
  1. The CTA question should have a response box checked for the following statement: “The PI’s hospital, university or medical center has a contract with WIRB for IRB services, and it has an established process for ensuring that the compensation of injury language in the CTA and in the consent form do not conflict."
  2. Name of Institution, please enter: “University of Wisconsin-Madison.”
  3. Do not fill in any of the CTA questions except the ones noted above.
  4. Do not sign any portion of the CTA area in the WIRB application.
  5. Please do not scan the UW CTA Form into your initial application pdf file. Send the signed CTA form as a separate pdf file. The University of Wisconsin-Madison will keep record of the CTA agreement form.



Keywords:initial, wirb application, wirb app, initial app, initial application, site, billing, state law, CTA   Doc ID:22370
Owner:Mike B.Group:Western Institutional Review Boards
Created:2012-01-24 12:27 CSTUpdated:2016-04-11 06:37 CST
Sites:Western Institutional Review Boards
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