Sample Release Letter Template

AMPLE

ELEASE

ETTER

/ U

LEASE

OSPITAL

NIVERSITY

ETTERHEAD

Date of Request:

Mitchell Reddish, PhD

Chairperson

Liberty IRB, Inc.

1450 S. Woodland Blvd.

Suite 300A

DeLand, FL 32720

386.279.4313

RE: Sponsor: _________________________________________

Protocol # ________________________________________

Dear Dr. Reddish:

Our hospital/ university [does/ does not] maintain an

Institutional Review Board. This is to confirm that [hospital/

university name], hereby authorizes Liberty IRB, Inc. to be the

reviewing IRB on the above listed protocol. This institution [does/

does not] want to be copied on study related materials.

Sincerely,

[Name]

[Title]

(Can be signed by either a Hospital Administrator, or the IRB

Chairperson.)

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Parent category: Letters