Form: Annual Research Study Status and End-of-Study Report | Research Ethics Board

File

Max. file size: 256 MB.

Title of Research Project/Course*

Application Number*

Date of Original REB Approval*

Today's Date*

Principal Investigator

Name*

First Last

School/Department*

Telephone & Extension*

Email*

Enter Email Confirm Email

1. When did this study begin?*

2. Is this study still active?*

Yes

No

If YES, when will the study be completed?*

If NO, when was the study completed?*

3. What is the funding status of the project?*

Funded

Funding Sought

Unfunded

If funded, enter agency

If funding is sought, enter agency

Funding Period Start Date:

Funding Period End Date:

4. Have there been procedural or other changes to this application since its original ethics clearance?*

Yes

No

If yes, has a Change Request form been filed and/or attached?

A Change Request form has been filed

A Change Request form is attached

5. Since original ethics clearance was granted, have any ethical concerns arisen or have any participants experienced adverse events as a result of their participation in the study?*

Yes

No

If the answer to the previous question is yes, please explain:*

Name of Principal Investigator/Supervisor*

First Last

Date*