UNMC Human Subjects Research - Comment Portal

The University of Nebraska Medical Center (UNMC) and Nebraska Medicine (NM), Bellevue Medical Center, UNO, and Children's Hospital & Medical Center work hard to ensure that human subjects research is conducted in manner that all persons involved feel safe and secure throughout the entire process.

This short form allows you, as a participant or observer of human subjects research at the institution, to submit a comment, complaint, or concern. These will be reviewed by UNMC's Institutional Review Board (IRB) through the Office of Regulatory Affairs.

Your report will remain anonymous, unless you would like to be contacted by the IRB and/or would like to include your name and contact information.

Thank you for taking the time to help us keep research subjects and others safe!

Have you reported this specific concern previously through this portal?

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Yes

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To allow us to look up that report, please provide the "Reference Number" you received when submitting the prior report. If you do not have this number, provide any details that would help us match the reports.

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In the text box below, please describe your concerns in as much detail as you can.

If it involves a particular research protocol: please include the IRB number ("IRB XXX-XX" on the consent form if there is one) or title of the research study, if you know it.

If your concern is related to a particular event: including the dates and names of people involved would be helpful.

The more information you include, the better we will be able to investigate.

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Please provide your "role" in human subjects research:

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Research subject/patient

Investigator/Physician

Coordinator/Administrator

Other employee of the institution

Other observer

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Please describe "Other observer":
(i.e. spouse of participant, visitor to the hospital, etc)

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While you will remain anonymous by not providing your details below, we would like to provide an opportunity for you to attach your name, email, and/or phone to this report if desired.

Furthermore, please provide these details if you would like to be contacted for more information, to discuss the event, or to be informed of the results of our investigation.

Note: Even if you provide this information, we will not share it with others involved without first asking for your permission.

NAME:

EMAIL:

PHONE:

As you have requested to be contacted, please be sure to provide your details above.

Would you like to be contacted by the IRB?

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Yes

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You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.