Proposal Central Log In Home Committees Education Mentoring CommitteeSteering CommitteeAdvisory CommitteeSenior Advisory Committee Contact UsNews IUIS TRAVEL SCHOLARSHIP AWARDS Resource LinksResearch Grants Research Subcontracts Research Awards Repository Repository Info Advisory Panel Education Mentoring Programs Summer School »Travel Scholarships »Visiting Immunology Scholar »Fellow/Scientist Training Program Mentoring 2005 Summer School Travel Grantees Commentary AWARDS - Short Term Training Disease Registry Registries Info Registries - Demo Registries Live Registries – Forms » IRB Resource Documents » Scientific Advisory Committee » REGISTRY GUIDE – Coming Soon INTRODUCTION – Coming Soon USER AGREEMENT – Coming Soon REQUEST FOR LOGIN AND PASSWORD – Coming Soon PATIENT FORMS » REGISTRY - CORE REPORT (USE FOR ALL ENTRIES) REGISTRY – DISEASE SPECIFIC (USE ONE FOR MOST ENTRIES) » AGAMMAGLOBULINEMIA, X-LINKED AND AR CHRONIC GRANULOMATUS DISEASE COMPLEMENT DEFICIENCIES CVID AND OTHER HYPOGAMMAGLOBULINEMIAS DIGEORGE SYNDROME HYPER IGM SYNDROMES LEUKOCYTE ADHESION DEFICIENCY NEMO and NF-kB RELATED DISORDERS SEVERE COMBINED IMMUNE DEFICIENCY/CID WISKOTT-ALDRICH SYNDROME USIDNET -Western IRB » Mt.Sinai School of Medicine » CHOP » NIH/Intramural NIAID » Disease Specific Working Groups WIRB Submission » WIRB Approved Clinical Protocol WIRB Approved Informed Consent (English) WIRB Approved Informed Consent (Spanish) WIRB Waiver of Authorization 2006 WIRB Certificate of Approval 2006 WIRB Renewal Certificate 2007 Clinical Protocol Summary IRB - Sample document Research Application Research Participant Information Sheet Modification of Informed Consent Clinical Data Review Form Request for Waiver Authorization Request Access Health Info for use of de-identified data Progress report IRB - Annual Adverse Event Report IRB - Annual Enrollment HIPPA - Child Authorization HIPPA - Decedent Authorization HIPPA - Authorization IRB Assurances Clinical Protocol Consent to Participant Letter to IRB NIH - IRB Letter of Approval NIH - Adult Consent to Participate NIH - Child Consent to Participate Clinical Protocol Data Entry Forms Registry Consent Form Registry Informed Form Letter to WIRB and Response 2-part Informed Consent Contact Us Thank you for your interest in The US Immunodeficiency Network (USIDNET).  In an effort to answer your specific inquiries, the following information is provided for your convenience ___________________________________________________ Mail or FedEx send to:    US Immunodeficiency Network                                             40 W. Chesapeake Ave., Suite 308                                            Towson, MD 21204-4803   USA   Email Inquiries: tbrown@primaryimmune.org Direct Line:       (443) 632-2542 Fax:                   (410) 321-9165   Administration      Ann Vukelich           Project Officer     Sarah Bush           Registry Manager   Tamara Brown       Contract Manager

      USIDNET is funded by The National Institute of Allergy and Infectious Diseases (NIAID) and The National Institute of Child Health and Human Development (NICHD), which are components of the National Institutes of Health (NIH), an agency of the Department of Health and Human Services. NIAID supports research to advance the understanding of transplantation and to prevent, diagnose and treat infectious and immune-mediated illnesses. USIDNET administrative support is provided by the
Immune Deficiency Foundation (IDF) .

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