Laws & Guidance GRANTS & CONTRACTS
U.S. Department of Education Sample Independent Investigator Agreement
Downloadable File MS Word (54 KB)

(Revised May 2011)

This agreement is for investigators who will be conducting research under a U.S. Department of Education (ED) sponsored or conducted project when acting in their own name, independent of any institution.

Prepare submission using the MS Word Version (Link to MS Word Version).

Name of Independent Investigator: ____________________________________________

Name of Institution with the Assurance: __________________________________________
- (footnote 1)

Part A. Ethical Principles

1. __________________________________(name of independent investigator), hereinafter referred to as the "investigator," in the following ED-sponsored or conducted project:

a. _____________________________________________ (Project Title)

b. _____________________________________________ (PR/Award or RFP Number)

is guided by the ethical principles regarding all research involving human subjects as set forth in the report of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research entitled Ethical Principles and Guidelines for the Protection of Human Subjects of Research (the "Belmont Report").

2. Accordingly, this investigator understands and shall abide by the principles of respect for persons, minimization of risks, maximization of benefits, and fairness as stated in the Belmont Report, and shall apply these principles in all research covered by this Agreement.

Part B. Responsibilities of Investigator

1. This investigator acknowledges and accepts responsibility for protecting the rights and welfare of human research subjects.

2. This investigator assures that before human subjects are involved in research, proper consideration will be given to:

  1. the risks to the subjects;
  2. the anticipated benefits to the subjects and others;
  3. the importance of the knowledge that may reasonably be expected to result;
  4. the informed consent process to be employed;
  5. the provisions to protect the privacy of subjects;
  6. the need for additional safeguards for vulnerable populations; and
  7. the need for compensation due to subjects in the case of harms they suffer as a result of the research.

3. This investigator accepts responsibility for his/her performance in this research project and will protect human research subjects and satisfy the intent and procedures as specified in 34 CFR Part 97, as amended, and other Federal, state, or local laws or regulations which may apply.

4. This investigator will comply with all other pertinent procedures, such as prior review by an appropriately designated Institutional Review Board (IRB) and informed consent, that are designed to ensure effective application of protections for the rights and welfare of human subjects.

5. This investigator will abide by the reviews of the IRB designated below and will accept the final authority and decisions of that IRB.

6. This investigator acknowledges and agrees to cooperate in the IRB's responsibility for initial and continuing IRB reviews, recordkeeping, reporting and certification. In addition, continuing reviews will be preceded by progress reports to include overall findings of this project.

7. This investigator specifically acknowledges the need to promptly report the following to the designated IRB:

  1. any proposed changes in IRB-approved protocols, and agrees not to initiate such changes without prior IRB review and approval except to eliminate apparent immediate hazards to subjects, and

  2. any injuries to subjects or unanticipated problems involving risks to subjects or others.

8. This investigator agrees not to accrue subjects on protocols for this project prior to approval of this Agreement and without certification of IRB review for each additional research activity that may be added to it.

9. Continuing IRB reviews must be conducted at least annually and may be conducted more frequently at the discretion of the IRB (34 CFR 109.2). Minor changes may be expedited (34 CFR 110(b)).

10. This investigator understands that he or she may not participate in convened discussion or voting of the IRB except by invited attendance to provide information to the IRB upon request (34 CFR 97.107(e)).

11. The investigator understands and shall comply fully with the requirements of all applicable Federal policies and guidelines, including those concerning confidentiality of information about subjects, Student Rights in Research, Experimental Programs, and Testing, also known as the Protection of Pupil Rights Amendment (PPRA) (34 CFR Part 98), and Family Educational Rights and Privacy (FERPA) (34 CFR Part 99) - (footnote 2).

12. This investigator agrees not to refer subjects accrued for protocols approved for this project by the IRB for the purpose of other research without prior IRB notification.

Part C. Responsibilities of the Designated IRB

1. The IRB and its host institution, which are designated below, agree to abide by 34 CFR Part 97, the cited Assurance, this Agreement, and all applicable Federal policies and guidelines, including those concerning confidentiality of information about subjects, Student Rights in Research, Experimental Programs, and Testing, also known as the Protection of Pupil Rights Amendment (PPRA) (34 CFR Part 98), and Family Educational Rights and Privacy (FERPA) (34 CFR Part 99).

2. The IRB membership satisfies the compositional requirements of 34 CFR 97.107 and, if applicable, 34 CFR 350.4 or 356.3 - (footnote 3).

3. It is agreed that the IRB shall require receipt of progress reports from the independent investigator on at least an annual basis or more frequently depending on the degree of risk.

4. The IRB shall report promptly to ED officials and institutional official of the IRB named in this Agreement:

  1. any serious or continuing noncompliance by the investigator with the requirements of the IRB;
  2. any suspension or termination of IRB approval;
  3. any unanticipated problems or injuries involving risks to subjects or others; and
  4. any changes in the research activity (ies) for award which are reviewed and approved by the IRB.
Part D. Endorsements

1. Designation of the IRB of Record

a. This investigator has designated and reached agreement with officials of an institution, named in D.2.a. below, for the following project:

i._________________________________________ (Project Title)

ii._________________________________________(PR/Award or RFP Number)

b. The institution is in possession of an applicable Assurance (footnote 1) and will provide the IRB of Record for this Agreement:

i._________________________________________(Assurance Number)

ii._________________________________________(IRB Number, if any)

c. Statement and Signature of the Independent Investigator

I assure that I will abide by the principles and responsibilities set forth in Parts A. and B. of this Agreement:

Signature: __________________________________Date: ___________

Address: ______________________________________________________

_______________________________________________________________

_______________________________________________________________

Telephone: _____________________ FAX: _____________________

E-Mail Address: _________________________________________________

2. Institutional Official and IRB Chair Statements and Signatures

a. _________________________________________________________ (name of institution) is in possession of the Assurance cited in D.1.b. above.

b. The IRB and institution agree to be cognizant of the contents of this Agreement and to act in concert with all its requirements, in addition to those of its ED-approved Assurance.

c. Institutional Official (Authorized Official of the Institution with the IRB)

Signature: ____________________________________Date: ____________

Name and Title:_____________________________________________________

Address: __________________________________________________________

__________________________________________________________________

__________________________________________________________________

Telephone: _______________________ FAX: ________________________

E-Mail Address: ____________________________________________________

d. IRB Chairperson

Signature: ____________________________________Date: ____________

Name: ____________________________________________________________

Address: __________________________________________________________

__________________________________________________________________

__________________________________________________________________

Telephone: _______________________ FAX: ________________________

E-Mail Address: ____________________________________________________

Part E.
Institutional Review Board (IRB) Membership Roster (Attachment to Independent Investigator Agreement)

Name of Institution:

Assurance Number:
IRB Number, if applicable:

Note: The membership roster (names, etc., of the IRB members) is not required if the IRB is registered with the Office for Human Research Protections (OHRP), unless requested by ED, or if the research is subject to the additional requirements in 34 CFR 350.4 or 356.3

Name

(Last, First, Middle Initial)

Highest Degree(s) Earned Primary Scientific or Nonscientific Specialty Affiliation with Institution(s) above (Yes/No; If yes, which one) Gender (Indicate Male or Female)
*        
**        
         
         
         
         
         
***        

* Denotes chairperson.

** Denotes the person(s) meant to comply with the requirements in Title 34, Code of Federal Regulations, Parts 350 and 356, if applicable (footnote 3).

***Denotes non-voting members, if any.

The research investigator(s) for the research project/activity(ies) for which this Assurance is provided may not be shown as voting members on the designated IRB. If their names appear on the roster, a footnote is required that states that they are to be absent from reviews in which they have a vested interest except as provided in the regulations.

Space Below for ED

All parts of this Agreement are in compliance with the requirements of 34 CFR Part 97 and, if applicable, Parts 350 and 356.

In addition to Part 97, this activity is also governed by:

____________Part 350

____________Part 356

ED Recommending Official

Signature: _______________________________ Date: _________________

Protection of Human Subjects Coordinator

Address:

Office of the Chief Financial Officer
U.S. Department of Education
Room 6144, Potomac Center Plaza
550 12th Street, SW
Washington, D.C. 20202-4250

Telephone: (202) 245-8090 Fax: (202) 245-0162

ED Approving Official

Signature: _______________________________ Date: _________________

 

Address:

Office of the Chief Financial Officer
U.S. Department of Education
Room 6144, Potomac Center Plaza
550th 12th Street, SW
Washington, D.C. 20202-4250

Telephone: (202) 245-8090 Fax: (202) 245-0162

Agreement Number_________________


Notes to text:

Footnote 1: ED will accept a Federal Wide Assurance (FWA) issued by the U.S. Department of Health and Human Services, Office for Human Research Protections (OHRP), if the assurance is current and applicable to the project cited in this Agreement.

Footnote 2: 34 CFR Part 98, the Protection of Pupil Rights Amendment (PPRA), is intended to protect the rights of parents and students in programs that receive funding from the Department of Education. It seeks to ensure that schools and contractors make instructional materials available for inspection by parents if used in connection with a Department of Education-funded survey, analysis, or evaluation in which their children participate, and it seeks to ensure that schools and contractors obtain written parental consent before minor students are required to participate in a Department of Education-funded survey, analysis, or evaluation that reveals certain personal information.

34 CFR Part 99, the Family Educational Rights and Privacy Act (FERPA), is designed to protect the privacy of a student's education records at all public elementary and secondary schools and virtually all public and private postsecondary institutions. It affords parents or eligible students the right to inspect and review all of the student's education records maintained by the school, gives parents and eligible students the right to request that a school correct records believed to be inaccurate or misleading, and generally requires a school to have written permission from the parents or eligible student before releasing any information from a student's record, except to certain parties.

Footnote 3: 34 CFR Part 350 and 34 CFR Part 356 impose additional Institutional Review Board (IRB) membership requirements in certain projects sponsored by the National Institute on Disability and Rehabilitation Research. When an IRB reviews research that purposefully requires inclusion of children with disabilities or individuals with mental disabilities as research subjects, the IRB must include at least one person primarily concerned with the welfare of these research subjects.

Protection of Human Subjects in Research page

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Last Modified: 05/19/2011