IRB Forms


Protocol Submission Forms and Samples

All forms and samples are new, August 2013


  • IRB Protocol Face Sheet (Appendix A). For use by WPUNJ faculty, staff and doctoral students.

Word, PDF  (fillable form)

Instructions for the preparation and submission of a protocol by WPU faculty, staff and doctoral students using Appendix A, Protocol Face Sheet

  • External IRB Protocol Face Sheet (Appendix B). For use by investigators (faculty, staff or student) from other institutions seeking to conduct research at WPU.

WordPDF  (fillable form)

  • Undergraduate and Master's Degree Student Research Protocol Review Request (Appendix C). For use by WPUNJ Undergraduate and Master's Degree students only. Includes sample Informed Consent Statements

PDF  (fillable form)


Student Research FAQ

  • Continuing Review Face Sheet (Appendix D). For use by faculty, staff and outside researchers.

Paper Forms: WordPDF  (fillable form)

Electronic Form:

  • Sample Statements for Informed Consent Forms (Appendix E). For use by faculty, staff, students, and outside researchers. Includes sample statements of active consent, passive consent, and consent for more-than-minimal risk research. 

Word, PDF  (NEW)

  • Sample Venipuncture Consent Statement (Appendix F).


  • Sample Indemnification Clause (Appendix G).


  • Protocol Review Form (Appendix H, for IRB Committee use only)

WordPDF (fillable form)

PDF to use in Acrobat Pro


Instruction Only Certification

WPU-AFT Agreement

Instruction Only Certification Form (.PDF)


Policy on Human Subject Research at William Paterson University (2014)

Policy on Human Subject Research at William Paterson University (2006)

Resolution Concerning Return of Protocol Approval Notices

Guidelines for the Preparation of Protocols for Review (The "Old Policy," superceded by Policy on Human Subject Research in February 2006)