Vulnerable Populations Research Ethics Compliance Form
1. Research Project Information
Project Title
Principal Investigator (PI) Name
PI Email
Department / Institution
2. Description of Involvement
Describe the involvement of vulnerable populations in your research
3. Vulnerable Population Groups (Check all that apply)
Children (minors)
Pregnant Women
Prisoners
Economically or Educationally Disadvantaged
Cognitively/Decisionally Impaired
Other (Specify)
4. Risks and Protections
Potential Risks
Measures Taken to Minimize Risks
5. Informed Consent Procedures
Describe consent/assent process and procedures for participants
6. Additional Comments
Date
Signature of Principal Investigator