Forms & Templates

DePaul University researchers can download and complete submission forms for research involving recombinant or synthetic nucleic acid molecules and biohazardous agents.

Before submitting an application, please follow the below protocol preparation guidelines:

• If this is your first time going through the IBC, please review the Getting Started webpage.
• Determine the risk level of the agent and the Biosafety Containment Level (BSL). Currently, only research or teaching activities meeting the criteria for either BSL 1 or 2 containment procedures can be conducted at DePaul University. Information on the BSL and Risk Group Levels can be found in the Risk Groups & Biosafety webpage.

Initial Application Documents

• Application for Research Activities Involving Recombinant and Synthetic Nucleic Acid Molecules (NIH Non-Exempt), Other Biohazardous Agents, and Human Materials (initial protocol application)

This form is to be used to obtain IBC approval for research activities involving NIH non-exempt recombinant and synthetic nucleic acid molecules, other biohazardous agents (e.g., biological toxins, CDC/HHS/USDA-APHIS select agents and toxins, or infectious materials), human materials (e.g., blood, saliva, urine, tissue, cell lines), or NIH exempt recombinant and synthetic nucleic acid molecules when they are used in a protocol with other biohazardous agents or NIH non-exempt recombinant and synthetic nucleic acid molecules.
Posted: 07/13/2017

• Instructions for the Application for Research Activities Involving Recombinant and Synthetic Nucleic Acid Molecules (NIH Non-Exempt), Other Biohazardous Agents and Human Materials

Instructions for the Application for Research Activities Involving Recombinant and Synthetic Nucleic Acid Molecules (NIH Non-Exempt), Other Biohazardous Agents, and Human Materials.
Posted: 09/12/2016

• Application for Research Activities that Involve Only Recombinant or Synthetic Nucleic Acid Molecules that are NIH Exempt (initial protocol application)

This form is to be used for research activities when all research activities are limited to the use of NIH exempt recombinant and synthetic nucleic acid molecules listed in Section III-F of the NIH Guidelines.
Posted: 12/14/2016

• Instructions for the Application for Research Activities that Involve Only Recombinant or Synthetic Nucleic Acid Molecules that are NIH Exempt

Instructions for the Application for Research Activities that Involve Only Recombinant or Synthetic Nucleic Acid Molecules that are NIH Exempt.
Posted: 09/12/2016

• Application for Teaching Activities Involving Biohazardous Agents - NIH Recombinant and Synthetic Nucleic Acid Molecules (Exempt and Non-Exempt), Other Biohazardous Agents, and Human Materials (initial protocol application)

This form is to be used to obtain IBC approval for teaching activities involving NIH exempt and non-exempt recombinant and synthetic nucleic acid molecules, other biohazardous agents (e.g. select agents or toxins, or infectious materials), or human materials (e.g. blood, saliva, urine, tissue, cell lines).
Posted: 07/13/2017

• Instructions for the Application for Teaching Activities Involving Biohazardous Agents (NIH Recombinant and Synthetic Nucleic Acid Molecules, Other Biohazardous Agents, and Human Materials)

Instructions for the Application for Teaching Activities Involving Biohazardous Agents (NIH Recombinant and Synthetic Nucleic Acid Molecules, Other Biohazardous Agents, and Human Materials).
Posted: 09/12/2016

Amendments, Adverse Event/Noncompliance, Renewal and Final Closure Report Documents

• Application for an Amendment Changing Personnel (not the PI) for an IBC Approved Protocol

This form is to be used when the personnel is removed or added to a protocol after the protocol has been initially approved by the IBC.
Posted: 09/12/2016

• Application for Amendments to Research and Teaching Activities that Require IBC Review and Approval

Use this form to obtain IBC approval for changes or additions to research and teaching activities involving NIH recombinant and synthetic nucleic acid molecules, other biohazardous agents, or human materials that have already been approved by the IBC.
Posted: 09/12/2016

• Adverse Biosafety Event and Non-Compliance Report Form

Use this form to report to the IBC any serious adverse events, any non-compliance with the NIH Guidelines, BMBL, or DePaul policy, or any significant research-related accident or illness leading to, or potentially leading to, harm or that is dangerous to humans, animals, and/or the environment.
Posted: 09/12/2016

• Annual Renewal Report Form

Use this form to report the protocol status annually to the IBC for your research or teaching activity utilizing biohazardous agents.
Posted: 09/12/2016

• Final Closure Report Form

Use this form to report to the IBC that your research or teaching activity utilizing biohazardous agents has been completed and you are closing the protocol.
Posted: 09/12/2016

Other Documents & Resources

• Hepatitis B Vaccination Acceptance-Declination Statement-new EHS
  

This form is to be used to document receipt of the hepatitis B vaccination, declination of the hepatitis B vaccination, or the desire to receive the Hepatitis B vaccination through DePaul. This form must be completed by all personnel working on a protocol with potential blood borne pathogen exposure as  potential risk.
Posted: 05/10/2019

• Background Information for hepatitis B Vaccination Declination Statement
  

This document provides background information as to why the IBC requires that personnel who have exposure to  human blood or other agents that may contain blood borne pathogens need to complete the Hepatitis B Vaccination/Declination Statement and submit that document with the IBC protocol materials to the IBC.
Posted: 05/10/2019

• Generic Vaccination/Declination Form

Use this form when your work requires a vaccination with something other than the Hepatitis B vaccination series. This form can be edited to any vaccination type.
Posted: 11/26/18 (revised)