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pdfIRB Authorization Agreement
Name of Institution Providing IRB Review: Emory University (Emory)
IRB Registration #: 00000569
Federalwide Assurance (FWA) #: 00005792
Name of Institution Relying on the Designated IRB: Public Health Solutions
FWA #: FWA00000489
The Officials signing below agree that Public Health Solutions may rely on the designated IRB for review and
continuing oversight of its human subjects research described below:
This agreement is limited to the following specific protocol:
Emory IRB File #: 85716
Study Title: Mobile Messaging Intervention to Present New HIV Prevention Options for MSM
Emory PI: Patrick Sullivan, PhD
Public Health Solutions PI: Sabina Hirshfield, PhD
Funding Agency: Centers for Disease Control
The review performed by the designated IRB will meet the human subject protection requirements of Public Health
Solutions’s OHRP-approved FWA. The IRB at Emory University will follow written procedures for reporting its
findings and actions to appropriate officials at Public Health Solutions. Relevant minutes of IRB meetings will be
made available to Public Health Solutions upon request. Public Health Solutions remains responsible for ensuring
compliance with the IRB’s determinations and with the Terms of its OHRP-approved FWA. This document must be
kept on file by both parties and provided to OHRP upon request.
Signature of Emory University Signatory Official:
_______________________________________________
David L. Wynes, PhD
Vice-President for Research Administration
1599 Clifton Rd NE
Atlanta, GA 30322
david.wynes@emory.edu
404-727-3889
Date: ________________
Signature of Public Health Solutions Signatory Official:
_______________________________________________
Date: ___02/02/2016_____________
Print Full Name: ____Raymond Fink, PhD_____________________________
Institutional Title: __Institutional Review Board Chair_______________
Emory IRB Reviewing IAA Template
Form: 03012015
File Type | application/pdf |
File Title | Sample text for an Institution with a Federalwide Assurance (FWA) to rely on the IRB/IEC of another institution (institutions ma |
Author | waldenj |
File Modified | 2016-04-13 |
File Created | 2016-02-02 |