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Please provide some basic information here:

Training or Consultation Request

Type of Training or Consultation:

Individual
Group

During which time frame would you prefer the training or consultation to take place ?

Morning (8 am-11 am)
Midday (11 am-2 pm)
Afternoon (2 pm-5 pm)

Decisions about whether Einstein will enter into a reliance agreement for IRB review, whereby the Albert Einstein College of Medicine & Montefiore Medical Center will provide IRB review for other institutions (“Reviewing IRB”) or will rely on the IRB at another institution (“Relying Institution”), require consideration of specific information about the proposed research and the institutions that are involved. Reliance can be for a single study or series of studies, and the reviewing IRB in a reliance relationship can be referred to as a Reviewing IRB, a Single IRB or a Central IRB. For the purposes of this request, the IRB that will be responsible for IRB review in all such reliance relationships will be referred to as a "Reviewing IRB".

Reliance cannot begin until a reliance agreement has been reviewed and fully executed. The Einstein IRB Office will facilitate this process via iRIS.

If you are interested in participating in a multi-site project that proposes the use of a single IRB (sIRB),
Please follow the link below to complete an Einstein IRB Reliance Request Form:

- IRB Reliance Request Form -

Is this related to an existing iRIS protocol?

YES
NO

Please provide the iRIS Protocol #:

Please detail your question below:

Please provide details on why this training is being requested:

AECOM/MMC Principal Investigator Information:

Name:

Title:

Department:

Phone #:

Email:

Payroll:

Name of Person Completing this form:

(if different from above)

Name:

Title:

Phone #:

Email: