Appendix C

Site Permission Letter Template

For IRB Application directions/steps and all necessary forms/templates, please go to the Center for Graduate Studies Lounge
Click Content -> find Institutional Review Board (IRB) Process.
If you cannot locate a form, please contact IRB@Aspen.edu

Note: DNP Candidates – this is not the same thing as an immersion site agreement.

This letter is required from any clinic, institution, organization, company, group, etc. where you will conduct your study or implement your project. For example, if you are implementing a QI protocol at a clinic, the appropriate person at that clinic must give you permission. If you are interviewing/surveying faculty or teachers, then the appropriate person(s) at that college/university or district office and school must give you permission. If you are posting a recruitment announcement to a LinkedIn group, the group owner must give you permission. Your chair will assist you in determining the permissions you need for your specific project/study. When in doubt, contact the IRB: IRB@Aspen.edu and cc your chair on all communication.

The site you are working with may have a standard letter/template.

Please check with them before using the following template.

The letter must:

Be printed on letterhead (emails will not suffice)
Include your name
Include the title of your project/study
Include a 1-3 sentence purpose
Include a statement that your protocol has been reviewed
Include a statement about what is being permitted at the site
If applicable, clearly state any restrictions
Be signed by the appropriate person who attests that they have authority to grant such permission. For DNP candidates this is typically a Chief Medical Officer or Director. For EdD students this is typically an authority at a district office, like a superintendent, or a college/university department head.
Include the title of the signatory
Include an email address and phone number of the signatory

This is a sample template. If the signatory indicates they do not have their own template, then draft a letter using the template below, on their behalf. Replace the blue font with details from your study. Delete all other extraneous font. Before providing the document to the signatory, ensure that you have checked for spelling/grammar errors and that all the font is black. Be sure to communicate that the letter MUST be on letterhead when it is returned to you.

Date

Dear IRB Administrator,

After reviewing the proposed Doctoral Project/Dissertation: Title of Your Project/Study, I have granted authorization for Doctoral Candidate’s Name to conduct the project/study at our

Clinic/Hospital/School/Company/Organization, and I attest that I have the authority to grant such permission. [If you are collecting data from a school you need permission from both the district office and from each school as schools may have different criteria for what can be collected and how they will help]

I understand the purpose of the project/study is to state the brief purpose of your project/study.

[Articulate the purpose of in layman’s terms in 1 – 3 sentences]

[The next section of the letter must articulate exactly what activities will occur at the site]

The Clinic/Hospital/School/ Company/Organization will allow the following over the duration of the project/study:

Examples

Assess knowledge of the ED staff and guidelines published by the Emergency Nurse Associations (ENA) evidence-based, clinical practice guidelines (CPG) on Difficult Intravenous as a quality practice initiative for staff/providers/participants related to a new evidence-based intervention at Aspen University Hospital’s Emergency Room.
Work with the quality department or the facilities designated specialist to gather de- identified patient data specific to the measurable patient outcome.
Nurse Nancy is required to follow all HIPPA and all Personal Health Information (PHI) policy and procedures related to obtaining, storing, and destroying of HIPPA and PHI protected data.
Interview teachers in their classrooms during lunch (I have reviewed the semi-structured interview questions).
Send emails to employees inviting them to take an online survey assessing perceptions of leadership (I have reviewed the survey).
Post a flyer in the main building common area and use a private office for interviews (I have reviewed both the flyer and the interview questions).
Access to de-identified client data and will be required to submit a copy of their final dissertation manuscript.

If the IRB has any concerns about the permission being granted by this letter, please contact me by phone or email [whatever is the preference of the person granting permission].

Sincerely,

[Authorizing Official’s signature - a ‘wet’ signature is best; however, an e-signature is sufficient]

Title [The signatory must be an administrator with oversight and responsibility over the clinic/hospital/school/company/organization]

phone number email

address [if address does not appear in letterhead]