812.238.7000 for Union Hospital Terre Haute
765.832.1234 for Union Hospital Clinton

Union Health

The Research Review & Compliance (RRC) Department at Union Hospital, Inc. serves as a hub for all research studies taking place on Union Hospital grounds.

A Research Authorization Application (RAA) should be submitted by any individual conducting research or completing a student project on the campus of Union Hospital, Inc. Approval must be given by the Research Review & Compliance (RRC) Department prior to the start of any research procecdures.

Research Authorization Application (RAA) - Electronically Fillable (Note: After completed this must be printed and submitted to RRC. Completed forms cannot be saved.)
Research Authorization Application (RAA)

Completed forms may be submitted to the RRC at Union Hospital:

Research Review & Compliance Department
Richard. G. Lugar Center for Rural Health
1433 N 6 1/2 Street
Terre Haute, IN 47807

-or-

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Forms

Research Authorization Application 
IRB Application
Waiver - HIPAA 
Authorization to Use and Disclose PHI
Financial Interest Disclosure 
Continuing Review/Termination of Research Involving Human Subjects
Individual Investigator Agreement
Informed Consent Guidance
Informed Consent Template
Request to Withdraw from a Research Study (Patient)
IRB Closure Form