Department of Pediatrics - Pediatric Clinical Research Office

PCRO Forms

View a flowchart of the research proposal process.

Forms

  • PCRO Clinical Research Proposal Sign-Off Form and Request for Scientific Review Form
    The PCRO Clinical Research Proposal Sign-Off and Request for Scientific Review Form Sign-Off form is used to obtain Department of Pediatrics/PCRO approval and request for PCRO Scientific Review. This form is to be completed by the Principal Investigator and returned to the PCRO Office.  
  • University of Rochester Proposal Sign-Off Form 
    This form is required by the Office of Research and Project Administration to (ORPA) request approval/sign-off for proposals. This form is to be completed by the Principal Investigator and then returned to Pediatric Research Administration who will review and forward to ORPA.
  • University of Rochester Proposal Sign-Off Form for Industry Sponsored Trials 
    This form is required by the Office of Research and Project Administration to (ORPA) request approval/sign-off for industry-sponsored clinical trials. This form is to be completed by the Principal Investigator and then returned to Pediatric Research Administration who will review and forward to ORPA.
  • Strong Memorial Hospital Clinical Laboratory Research Study Set up Request
    This form is used by Strong Memorial Hospital (SMH) Clinical Laboratories to establish an account for laboratory services for a study. This form is completed by the Principal Investigator and returned to SMH Clinical Laboratories.
  • Strong Memorial Hospital Clinical Laboratory Research Test Price Request 
    This form is completed by the Principal Investigator to obtain price quotes/estimates for laboratory services and is and returned to SMH Clinical Laboratories.
  • Perinatal Research Committee Application
    This form is used to request scientific review of a study proposed to access SMH perinatal/neonatal patients, specimens or data. This form is now included in the RSRB electronic application.
  • University of Rochester Disclosure Form for Conflict of Interest Related to Research Activities
    This form is to be completed by the Principal Investigator as required by University policy to identify any existing or potential Conflicts of Interest. Completion of this form also fulfill federal grant requirements for disclosure of financial interests in research.
  • PCRO Five Year Renewal Progress Report Form 
    This form need to be completed by the Principal Investigator or the Study Coordinator and submitted with the PCRO Clinical Research Proposal Sign-Off and Request for Scientific Review Form for all RSRB five-year renewal applications.
  • PCRO Cost/Subject/Visit Budget Form 
    This Budget Matrix can be used by the Principal Investigator and/or Study Coordinator to assist in the development of the Cost/Subject/Visit costs associated for each Subject planned for the study so as to assist in the determination of the overall study cost.
  • PCRO IRB Approval Matrix
    IRB applications submitted by the Principal Investigator from the Department of Pediatrics requires Scientific Review recommendation of approval, and approval by the Office of the Chair of the Department of Pediatrics. Departmental approval of IRB applications is coordinated through the PCRO. The IRB Approval Matrix provides a check-list of steps necessary in this process.
  • PCRO Video Release Form
    All content and/or video relating to clinical trials and/or other research studies must be approved by the PCRO before the content is added to the World Wide Web or the University of Rochester Intranet. The Principal Investigator or Study Coordinator must complete the PCRO Video Approval Form and return to the PCRO Office.

 

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Mission

The mission of the PCRO is to facilitate clinical research of the highest quality ensuring the safety of children.