Case Study Research Ethics Approval Request

Applicant Information

Full Name Email Department / Affiliation Position/Role

Project Information

Project Title Project Summary Location(s) of Research Estimated Start Date Estimated End Date

Case Study Details

Purpose and Objectives Methodology / Data Collection Methods Participant Selection Criteria Number of Participants Are vulnerable populations involved?

Consent and Confidentiality

How will informed consent be obtained? How will confidentiality and privacy be maintained?

Risk and Benefit Assessment

Potential Risks to Participants Mitigation Strategies Expected Benefits

Data Storage and Management

Where and how will data be stored? Who will have access to the data? How long will data be retained?

Additional Comments

Further Information (if any)