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Institutional Review Board Application
Institutional Review Board Amendment
Institutional Review Board Amendment
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Submit a formal request to amend or modify an existing GRCC Institutional Review Board (IRB) approved research study, protocol, consent form, research staff, or recruitment materials.
Status
The status of the ticket. This indicates where the ticket is in its lifecycle.
New
Open
In Process
Resolved
Cancelled
On Hold
Waiting On Customer Input
Trash
Do not use
Approved Research Title
What are you amending?
What are you amending?
Research Title
Primary Investigator
Co-investigator 1
Co-investigator 2
Data Collection Method
Data Storage procedures
Data purging procedures
Study timelines
Documented conflict of interest
Participant selection criteria
Participant informed consent criteria
Plans for sharing results
Changing an aspect of the research that is not listed.
Research Title
Primary Investigator Name
Primary Investigator Email
Primary Investigator Phone
Co-investigator 1 Name
Co-investigator 1 Email
Co-investigator 1 Phone
Co-investigator 2 Name
Co-investigator 2 Email
Co-investigator 2 Phone
Data Collection Method
Data Storage procedures
Data purging procedures
Study timelines
Documented Conflict of Interest
Participant Selection Criteria
Participant Informed Consent Criteria
Plans for Sharing Results
Changes
Has the amendment been submitted to an external IRB?
No
Yes
What is the status of their review of your revisions? Keep in mind that unapproved revisions will delay GRCC approval.
What is the status of their review of your revisions? Keep in mind that unapproved revisions will delay GRCC approval.
Agreements and Acknowledges
By submitting this amendment request, you agree to the following:
- Research will not resume unless and until final approval from the GRCC IRB is received.
- Investigators assure adherence to all approved research protocols for the duration of the study.
- Materials will be furnished immediately to GRCC IRB if a review is requested.
- Investigators will contact the GRCC IRB immediately if the need arises to amend or terminate an approved study or to report an adverse event.
- Receiving IRB approval to conduct research involving members of the GRCC community is not an endorsement by Grand Rapids Community College of this study nor the concepts that are eventually incorporated into any research output (dissertation, thesis, manuscript, working paper, poster, conference presentation, interview, etc., including any drafts or pre-publication versions).
- The investigator(s) is/are prepared to provide a final report for expedited or full committee approval within the specified timeframe following the study’s validity period.
- All questions have been answered truthfully and to the best of my ability.
- Failure to provide required documents will potentially delay review and approval processes.
Supporting Documentation - Please select and attach all required documents at the same time. If you try to attach more later, it will replace the ones you’ve already attached.
File attachments associated with the ticket.
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