Thank you for your desire to participate in this program!

Mayo Clinic will serve as the IRB of record.

The Mayo Clinic IRB serves as the central IRB for this study in the United States at the request of the U.S. Government.

To participate, you and your hospital need to rely on the Mayo Clinic IRB for this Expanded Access Program) protocol. In accordance with 45 CFR 46.103(e), agreeing to participate in the program by registering on https:USCOVIDplasma.org serves as documentation of each participating institution’s reliance on Mayo’s IRB.

A separate IRB reliance agreement is not required. The Mayo Clinic IRB is a nationally recognized IRB that is accredited by the Association for the Accreditation of Human Research Protection Programs.

Link to IRB Protocol: Protocol

Link to Consent Forms: English, Spanish, Arabic

Instructions:

You must complete this form to register as a local physician/PI including the Statement of Investigator FDA 1572, and the Patient Enrollment Form before your patient can receive convalescent plasma.

NOTE: Your site/ medical center can designate one physician/PI for this Expanded Access Program OR multiple physicians/ PIs can register for each site.

Information, protocol, consent forms and site registration, enrollment and followup forms are available at www.USCOVIDplasma.org.

If you have any questions or difficulties registering please email USCOVIDplasma@mayo.edu, which will be monitored from 7am-7pm CST.

Note: Submission of this form on iOS devices using Safari may cause duplicate submissions. If possible, please submit from another browser such as Google Chrome, Internet Explorer, or Mozilla Firefox. Thank you.

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