Institutional Review Board Approval Form
Project Information
Project Title
Principal Investigator
Department
Contact Information
Co-Investigators
Project Description
Brief Summary
Objectives / Purpose
Subject Information
Target Population
Number of Participants
Recruitment Methods
Data Collection & Security
Data Collection Procedures
Data Confidentiality Measures
Risk and Benefit Assessment
Possible Risks
Possible Benefits
Consent Process
Description of Consent Process
Approval
IRB Name
IRB Chairperson
Date of Approval
IRB Signature