Case Study Ethics Approval Form

Applicant Information

Full Name Position / Title Department / Organization Email Address Phone Number

Case Study Details

Case Study Title Purpose and Objectives Target Participants Methods of Data Collection Estimated Duration

Ethical Considerations

Potential Risks to Participants How will consent be obtained? How will privacy and confidentiality be ensured? Data will be anonymized

Review and Declaration

I confirm that the information provided is accurate and complete. Date Signature