translator certification 3 2010 by Nrv988


									                                                                                     3500 Fifth Avenue
                    University of Pittsburgh                                         Room 106
                    Institutional Review Board                                       Pittsburgh, PA 15213
                                      Translation Certification
NOTE: When studies are being conducted at foreign sites, all regulatory documents (e.g., approval letters,
summary of meeting minutes, permissions to conduct research at one or more foreign sites) and all
documents that will be presented to research subjects (e.g., consent forms, study information sheets,
recruitment materials) must be translated into English for the IRB. In addition to uploading those
documents (original non-English documents with English translations), investigators must complete this
form and upload it.

Name of Translator:

Contact Information:

Certified translator: Choose Yes or No
If Yes, provide the name of the organization providing certification:

If No, summarize translator’s qualifications to perform the translation services:


I certify that I have translated the following documents from English to          , and also provided a back
translation in English. By signing this form, I verify the accuracy of the translation to the best of my ability.

Signature of Translator: __________________________________                          Date:

Listing of documents translated:

Printed Name of Principal Investigator:

Study Title:

IRB Number:

Version 3/22/2010

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