Irb Protocol Sep081-1
Irb Protocol Sep081-1
Investigator’s Assurance
By submitting this protocol, I attest that I am aware of the applicable principles,
policies, regulations, and laws governing the protection of human subjects in
research and that I will be guided by them in the conduct of this research.
___________________________________________________________________________________
1. Download this New Projects IRB Protocol and save it on a floppy disk or on your
hard drive. You may then open it, type in all requested information, save the file
(please use your last name and New Project Protocol as the title: e.g., Musmar New
Project Protocol), and send the file as an e-mail attachment, along with your
informed consent letter(s), to the Institutional Review Board at
“ [email protected]”.
It is essential that you answer all questions on this form since this is the
primary source of information used by Board members to make their
decisions. Also, only include information necessary to answer the questions.
Please keep your responses as free of jargon as possible.
2. Please also send, by campus mail, all supporting materials that cannot be e-mailed
(e.g., measures, permission letters from off-campus sites) to the IRB at An-Najah
University, Nablus, Palestine. If your research requires review by the full Board,
you will be so notified and asked to provide an additional 12 copies of the
supporting materials.
1
PLEASE BE SURE TO COMPLETE ALL SECTIONS
If this is a revision in response to an IRB Report of Action (ROA)-approval pending, indicate the
date of the ROA: _______________________
2
(NOTE: If sites are administratively separate from the University, please submit approval letters, or
indicate when they will be forthcoming.)
Funding Agency (if applicable):______________________________________
In the judgment of the Principal Investigator, this research qualifies for which of the following
types of review:
Review Type: exempt (category) expedited (category) full Board1
Briefly describe the objective(s) of the research (please keep description jargon free and use 100
words or less; the IRB will file this information in our descriptions of approved projects).
III. METHODS
1
All research that is either externally funded or greater than minimal risk must be reviewed by the full Board
3
Describe exactly what will be done to subjects once they have agreed to participate in the project:
Are there potential legal risks to the Principal Investigator or University? Yes No _______
4
V. INFORMED CONSENT
Describe how participants will be informed about the research before they give their consent. Be sure
to submit with this protocol a copy of the informed consent/assent letter(s) you will use. Please prepare
your informed consent letter at the 8th grade reading level or lower as dictated by the needs of the
subjects. (See IRB website for required elements of an informed consent.)
VI. PRIVACY/CONFIDENTIALITY
Please describe whether the research would involve observation or intrusion in situations where
subjects have a reasonable expectation of privacy. If existing records are to be examined, has
appropriate permission been sought; i.e. from institutions, subjects, physicians? What specific
provisions have been made to protect the confidentiality of sensitive information about individuals?