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Research Administration
Fairview Health Services
2200 Riverside Avenue
Minneapolis, MN 55454
telephone: 612-672-7690
fax: 612-672-7691
email: Research Administration
Fairview Research Helpline:
telephone: 612-672-7692
or toll free: 866-508-6961
Forms: for conducting research at Fairview
Research Billing/Pricing:
Bill Form
Bill Form Instructions & Samples
E-Form
Fairview Research Account Request Form
Fairview Foundation Account Request Form
Fairview Foundation Account Request Form - Instructions
CPC Tray or Item Request Form
Request Form for Access to Fairview Systems
(including Electronic Medical Records)
Parking Services' parking coupon ("token notes")
Patient Information form for Investigational Drug Services (IDS)
Regulatory and Research Compliance:
Research Medical Record Form
Conflict of Interest Disclosure
(initial disclosure form)
Conflict of Interest Update Form
(to be completed at continuing review and when noting changes)
Investigator Certificate of Education
Lab Information and Certificates
Statement of Intent
Individual Investigator Agreement
External Access Agreement
(request form for an external reviewer to access clinical applications / information)
Unanticipated Problems Involving Risks to Subjects or Others (UPIRTSO)
UPIRTSO form Instructions
Adverse Event Assessment (decision tree) for UPIRTSO reporting
Non-Fairview Employed Research Staff
-
policy and application process
Research Recruitment:
Research Data Report Request Form
Recruitment Website Request Instructions
Recruitment Website Request Form
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