Minimal Risk Research Ethics Approval Request Form

1. Project Information

Project Title Principal Investigator Department / Affiliation Email Additional Investigators (if any)

2. Project Summary

Project Summary Research Objectives and Questions Estimated Project Duration

3. Methods

Brief Description of Methods Type of Data to be Collected Participant Involvement (number and type)

4. Risk Assessment

Explain Why the Research is Minimal Risk Risk Management Measures

5. Informed Consent

Describe the Consent Process Attach or Describe the Consent Form

6. Privacy and Confidentiality

Describe How Data Will Be Kept Confidential Describe Data Storage and Access Procedures

7. Additional Information

Additional Comments or Information