Revised VA Consent & Authorization Templates

March 23rd, 2015

As of March 1, 2015, the VA Consent and Authorization Templates have been updated in accordance with the November 12, 2014 version of VHA Handbook 1200.05. Revised templates are on the IRB website at

VA Consent Template Summary of Changes

  • The header information has been shortened.
  • The verbatim language in the “To Potential Participants” section and the “Research Participants’ Rights” section has been deleted.
  • A section has been added for investigators to disclose applicable financial conflicts of interest. 
  • Text has been added to the Confidentiality section regarding use of photographs, videos, and/or audio recordings for research purposes.  Use of a separate form (VA 10-3203) to obtain consent for use of photographs, videos, and/or audio recordings is no longer required.

VA Authorization Template Summary of Changes

  • VA Form 10-0493 is the newest version of the authorization form as required by the VA.  This form must be completed by the investigator an attached in ERICA for review. Investigators must ensure that information in the authorization form is consistent with information in the consent form.

All new studies submitted as of March 1, 2015, are required to use the new templates. All studies submitted and/or approved prior to March 1, 2015, may continue to use the previous templates.

If you have questions regarding any of these forms, please contact the VA Research Office at 801-584-1271.


  • Forms for Conducting Research at the VA

    Researchers conducting procedures at the Salt Lake City VA need to be aware of the additional administrative forms that may be required in addition to the IRB application.

  • Use of External Research Nurses

    The IRB has received several requests to allow the use of external research nurses who have contracted with a study sponsor to conduct research procedures with participants in their homes.

  • IRB Staff Changes

    We are pleased to welcome a new Coordinator to the IRB.

  • IRB Staff Changes

    Yan "Kiki" Wai, IRB Coordinator for Panel 2, has left the IRB. We are pleased to announce that Chantyl Staheli has been selected as the new IRB Coordinator for Panel 2.

  • Additional Exemption Categories

    The IRB is introducing Exemption Categories 8-11 as additional non-federal categories.