DECLARATION OF QUALIFIED TRANSLATORS
This form must be submitted along with both the forward and back translated document (or the
consensus translated document if two forward translations were done). Note that the forward
and back, or second forward translation, must be done independently by two individuals.
A summary of the translators' qualifications is required below. According to IRB policy,
appropriate translator credentials may include:
 a native speaker of the language (i.e., can speak, read and write) in the target language
 experience living where the language is spoken
 college-level preparation in the language
IRB #:
Type of Document:
Examples of type of document are consent form, consent form case, consent form control, assent form,
recruitment flyer, questionnaire, advertisement, survey. If there is no expiration date or footer date on the
English document (such as on a flyer), type N/A.
Approval date on
English document:
Expiration date on
English document:
Footer
Date:
Translation from English to (language):
Method of Translation:
Forward and Back Translation
Two Forward Translations
Name of Forward Translator:
Qualifications:
Declaration: I hereby certify that the translation referenced above is consistent in content, style,
and level of readability with the IRB-approved English document and the translation is true,
accurate, and correct "to the best of my knowledge and ability".
Signature:
Date:
Name of Back Translator:
Qualifications:
Declaration: The translation from the specified language back into English was done independent
of the forward translation and I did not see or refer to the English document when making this
translation. I hereby certify that the translation referenced above is true, accurate, and correct "to
the best of my knowledge and ability".
Signature:
Date:
Name of Second Forward Translator (if applicable):
Qualifications:
Declaration: I have reviewed the "forward" translation already done by the first translator and
compared it with the original English version. I hereby certify that the translation referenced above
is consistent in content, style, and level of readability with the IRB-approved English document and
the translation is true, accurate, and correct "to the best of my knowledge and ability".
Signature:
Date: