Applications and Guidelines

Plan to conduct an anonymous survey? You do not need an Informed Consent Form. Simply place the information that participants will read before they take the survey and label it Online Cover Sheet (for online surveys) or Tear-Off Cover Page (for paper surveys).

  • Select Applications for forms or to review sample applications
  • Select Appendices for required recruitment statements and informed consent forms
  • Select Guidelines and Forms for Ithaca College's Guidelines, federal regulations, HIPPA or Notice of Completion forms

Don't Forget to Include:

Appendix A
Recruitment Statement and/or flyer - what you plan to say to participants to encourage them to participate and/or the flyer you plan to post on campus

Appendix B
Informed Consent Form
If you plan to conduct an anonymous survey, you can use one of the following in place of the Informed Consent Form:

Appendix C
All Survey Instruments - questions, scales, tests, etc.

All applications will be deemed incomplete if they are not accompanied by the appropriate appendices.

Guidelines, Notice of Completion, HIPPA

Guidelines, Notice of Completion, HIPPA

Guidelines and additional forms can be found below:

Additional forms may be needed to complete the application or to close out the research study:

Notice of Completion of Human Participants Research Form

The Notice of Completion Form must be filled out after the data has been collected and when the risk to human participants is completed. Please note that review/approval of future proposals is contingent upon submission of this form. *If you have submitted a protocol through Axiom Mentor, you will need to complete your protocol there.

HIPPA Form - Health Insurance Portability and Accountability Act

The Health Insurance Portability and Accountability Act (HIPAA), also known as “The Privacy Rule,” sets standards and regulations to protect patients from inappropriate disclosures of their “protected health information” (PHI) that could cause harm to their insurability, employability and their privacy.