IRB Exempt Research Submission
Project Information
Project Title
Principal Investigator Name
Email Address
Department / Affiliation
Research Summary
Brief description of the research (purpose, methods, participants):
Exemption Category
Exemption Category (select all that apply):
Category 1
Category 2
Category 3
Category 4
Category 5
Category 6
Participant Information
Describe the participants and how they will be recruited:
Data Collection
Describe the data to be collected and methods:
Confidentiality
Describe how confidentiality of participants will be maintained:
Additional Information
Other relevant details (optional):