International Collaborative Research Ethics Approval Request Form

1. Project Information

Project Title Project Summary Proposed Start Date Proposed End Date Field(s) of Research

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2. Principal Investigator (PI) Information

Email Country

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3. Collaborating Institutions

List all collaborating institutions (name, country)

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4. Research Details

Brief Description of the Research Objectives Study Design & Methodology Countries Involved Data Collection Methods Type of Data/Samples to be Collected

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5. Ethics Approval Status

Has ethical approval been obtained from any institution? Yes No Pending If yes or pending, provide details (institutions, reference numbers, dates)

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6. Participant Information

Participant Groups (e.g. adults, children, vulnerable populations) Estimated Number of Participants Recruitment Procedures

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7. Data Protection and Confidentiality

How will data confidentiality and participant privacy be ensured? Data Storage and Security Procedures

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8. Other Relevant Information

Any ethical issues not covered above Comments or Additional Information

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9. Declaration

Declaration by Principal Investigator Date Signature