Vulnerable Populations Ethics Approval Request Form

Applicant Details

Name Position / Role Institution / Department Email

Project Details

Project Title Proposed Start Date Proposed End Date Project Summary

Vulnerable Population Details

Vulnerable Population Description Justification for Involvement Recruitment and Consent Process

Risk Assessment & Mitigation

Potential Risks to Participants Risk Mitigation Strategies

Additional Information

Confidentiality Measures Support Services Available

Declarations

I confirm that the information provided is accurate. I agree to comply with all applicable ethical standards and regulations.