DWEB-CMS2A
About Mercy

Initiating the Clinical Trial Application

To review a new study, the IRB needs the following:

  • A fully completed clinical trial application meeting Mercy Medical Center guidelines
  • A Patient Informed Consent Form revised to meet the standards of Mercy Medical Center
  • Protocol or Study Design
  • Investigators Drug Brochure or Instructions For Use Brochure
  • A completed (signed and dated) Financial Disclosure for every investigator listed on the application
  • A completed CV (signed and dated) for every investigator listed on the application (only needs to be submitted one time a calendar year)
  • A completed Billing and Allocation of Costs Guide
  • A completed Study Sponsor Information Sheet
  • Any other materials that would be used for patient incentive programs, patient education, or media advertising

This paperwork is required to be completed and submitted with an original date and signature. If any of the documents are not completed or parts are missing, your study will not be placed on the agenda.

You can send the above items through interoffice mail to: Marsha White – Medical Staff Office. If you need help in completing any of the forms, please contact Marsha at (515) 247-3985.

* PDF documents require Adobe Reader.

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