INVESTIGATORS

Primary Investigator



  

Co-Investigator



  

Is the Investigator a CVTC Student or Faculty member?

Did the Principal Investigator complete Human Subjects Training?

 

ABSTRACT



  

PROTECTED POPULATIONS

Please explain your justification for inclusion for all the protected populations included in this research.






RESEARCH INFORMATION

 
Research Plan – Please discuss the following in your response: what your proposed methodology is, how you plan to analyze your data, what your timeline is, etc.

 
Potential Risks – Please include any risks to participants including financial, health, etc.

 
Potential Benefits &ndash Please indicate any benefits to participants including financial, health, etc.

 
Incentives for Participants – If subjects will be paid or otherwise compensated or 'incentivized', indicate how much they will receive and how they will be compensated (e.g., check, gift card, voucher, etc.)

 
Conflict of Interest – Describe any conflict of interest that exists or may appear to exist as it relates to any of the investigators and this protocol. A conflict of interest exists if there is potential benefit to the investigator(s) beyond professional benefit from academic publication or presentation of the results.


It may be necessary to attach forms to best inform the IRB during the decision making process.
Please consider including the following forms:

  • Letter of Consent
  • Facility Approval (If applicable)
  • Original Submission Packet to your primary degree granting institution (If applicable)
Are you attaching a file?