Research Study Listing Form | College of Medicine – Jacksonville

IMPORTANT: All fields are required for new studies. Requests received without all fields completed, will not be processed. If you have any questions please contact us.

Indicate which type of request is being submitted:

Study Information

IRB Number:

IRB Approved Study Title:

Is this a Retrospective Chart Review study?

Description including inclusion/exclusion criteria and number of visits etc. (Information in this box should closely match the approved consent form but replace "you" to "participant" and adjust the rest of the description accordingly)