How to Submit a Chart Review

In order to submit your paperwork, you must go to the IRBManager web site at and submit on-line.  If you do not have an IRBManager account, please call Robert at 212-979-4447 to get one. Please keep in mind that a RETROSPECTIVE CHART REVIEW can only involve information from past Medical records. If your project involves ANY gathering of information in the future, your project is PROSPECTIVE and you must submit a complete NEW PROTOCOL for IRB review and approval before you can begin.

For Private patient's chart review

Submit abstract and Hipaa Researcher Certification Form.

For access to Hospital Medical Records

Submit abstract and Hipaa Researcher Certification form. Once Dr. Walsh has approved and signed, you must give this form to Mecial Records as proof you have met the Hospital/IRB's requirements for access to these records for review.

For access to HOSPITAL RECORDS only:

If the information you wish to collect and remove from HOSPITAL records is DE-IDENTIFIED (see De-ID form for instructions), fill this form out and submit along with your abstract.

If you are requesting to collect any information which meets the criteria listed in the Application to Receive a limited Data Set for research, this information may be accessed by a HOSPITAL EMPLOYEE or AGENT ONLY without first obtaining consent from patient. Please fill out this form and submit along with your abstract.

Once Dr. Walsh has determined that your chart review is in fact exempt from IRB review, he will inform the committee at the next regularly scheduled meeting.