Human Subjects Risk Assessment Form
Project Information
Project Title
Principal Investigator Name
Institution/Organization
Description of Human Subjects Involvement
Describe the involvement of human subjects in the project
Assessment of Risks to Subjects
Describe any potential risks to the subjects (physical, psychological, privacy, etc.)
Risk Minimization
Describe steps to minimize or manage these risks
Informed Consent
Explain how informed consent will be obtained from participants
Confidentiality
Explain how confidentiality of subjects and data will be protected
Vulnerable Populations
Will any vulnerable populations (e.g., minors, prisoners, pregnant women) be involved?
Yes
No
If yes, describe additional safeguards in place
Certification
Name of Person Completing Form
Date