Biomedical Research Ethical Approval Application Form
1. Project Information
Title of Research Project
Principal Investigator Name
Affiliation/Department
Contact Email
Contact Phone
Co-Investigators (if any)
2. Project Details
Research Summary
Objectives
Research Design/Methods
Study Location(s)
Duration of Study
3. Participants
Target Population
Estimated Number of Participants
Participant Inclusion Criteria
Participant Exclusion Criteria
4. Ethical Considerations
Potential Risks to Participants
Potential Benefits
How will informed consent be obtained?
Will participant confidentiality be ensured?
Yes
No
If yes, describe how:
5. Data Handling and Privacy
How will data be collected, stored, and protected?
Who will have access to the data?
6. Funding and Conflict of Interest
Source of Funding (if any)
Any potential conflict of interest?
Yes
No
If yes, provide details:
7. Attachments
Study Protocol
Sample Informed Consent
Questionnaires/Surveys
Other
8. Declaration
Date
Principal Investigator Signature