INSTITUTIONAL REVIEW BOARD
INVESTIGATION INVOLVING HUMAN SUBJECTS
PLEASE COMPLETE ALL QUESTIONS.
FACULTY ADVISOR INFORMATION (for student projects)
CONFLICTS OF INTEREST:
RESEARCH MATERIALS/APPARATUS: (Attach copies of any materials which are not standard, commercially available instruments)
INFORMED CONSENT: Attach copy of informed consent document if separate from research instruments (See guidelines for informed consent and sample consent forms)
INVESTIGATOR’S PLEDGE: I affirm the accuracy of this application, and I accept the responsibility for the conduct of this research, the supervision of human subjects, and maintenance of informed consent documentation as required by the Institutional Review Board. I will report promptly any unexpected or otherwise significant adverse effects encountered in the course of this study. This is to certify that the project identified above will be carried out as approved by the IRB, and will neither be modified nor carried out beyond the period approved without express review and approval by the IRB.
- Individual Investigator Agreement(s) (signed)
- Copy of informed consent document
ADDITIONAL ATTACHMENTS (as available or applicable)
- Any recruitment notices or advertisements
- Any survey instrument, psychological tests (other than standard, commercially available instruments), interview forms, or oral-
- Any interview scripts to be used in the research
- Formal research protocol, if available
- Grant application, if applicable
- Certificate of completion of education or training in the protection of human research subjects, if PI has one.
GRADUATE STUDENT REQUIREMENTS
- NIH Training Certificate
- Signed Approval of Graduate Research Proposal Form
Applications involving surveys of Hilbert College students, faculty, staff, or alumni will be forwarded to the Office of Institutional Advancement for inclusion on the college’s survey calendar.