Clinical Translational Research Center

Forms and Samples

Cincinnati Children’s Hospital Medical Center Clinical Translational Research Center offers investigators tools to assist with protocol submission.

Files are provided in portable document format (.pdf); the investigator-initiated and the industry-initiated protocol submission forms are also available as Word documents. Save the file to your computer, and then open it. You cannot fill in forms online. You must have Adobe  Reader installed on your computer to read the PDF files. You can download Adobe  Reader at Adobe’s website by selecting the version appropriate for your type of computer.

• Checklist for Protocol Submissions to CTRC Scientific Advisory Committee 2010 ( PDF )
• Monthly Deadlines for New Protocol Submission to CTRC Scientific Advisory Committee 2010 ( PDF )
• Investigator-Initiated Protocol Submission Form ( PDF )
• Industry-Initiated Protocol Submission Form ( PDF )
• Example of a Human Subjects Addendum (PDF)
• Example of an Ethnic Composition Table (PDF)
• Informed Consent Template from Institutional Review Board web page
• Conflict of Interest aka Significant Financial Interest Disclosure Form from CCRF Research Administration

Contact Us

For more information, contact Amy Hartkemeyer, administrative manager, 513-636-4273, amy.hartkemeyer@cchmc.org.