Ethics Committee Approval Form
Please fill out the following form to request approval from the ethics committee.
Study Title
Principal Investigator
First Name
Last Name
Affiliation
Date of Application
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Study Description
Study Design
Research Methods
Inclusion Criteria
Exclusion Criteria
Ethical Considerations
Funding Source
Conflicts of Interest
Study Timeline
Participant Consent Form
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Participant Information Sheet
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Declaration of Helsinki Compliance
Yes
No
Data Protection Compliance
Yes
No
Submitter Signature
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