TRAINING REQUIREMENTS: For more information, please see the IRB Training and COI Requirements” in the IRBNet Forms “Guidance- and Templates. CONFLICT OF INTEREST (COI) DISCLOSURES: For more information, please see the IRB Training and COI Requirements” “Guidance- in the IRBNet Forms and Templates. TABLE OF STUDY STAFF: See section 1 of this application for instructions. If additional space is needed, please continue on a separate page using the same format. f. a. b. c. d. e. Name & degree Role(s) on Project. Place of employment Will this person be Is this person an Will this person aid Examples: Principal obtaining verbal or for the “Investigator the shipment of Investigator, written Informed purposes of COI hazardous materials Coordinator, Consent/Authorization reporting”? (e.g., dangerous Consultant, Fellow, goods, specimens) to Resident, Student, THE PI IS ALWAYS be transported by a Research Healthcare CONSIDERED AN public carrier? Operations only, Access to INVESTIGATOR FOR de-identified data only, COI PURPOSES. For all Specimen shipment, etc. other team members see section 2.e. above. SUNY Downstate Yes No Yes No Yes No KCHC Other: SUNY Downstate Yes No Yes No Yes No KCHC Other: SUNY Downstate Yes No Yes No Yes No KCHC Other: SUNY Downstate Yes No Yes No Yes No KCHC Other: SUNY Downstate Yes No Yes No Yes No KCHC SUNY Downstate Yes No Yes No Yes No KCHC Other:
TRAINING REQUIREMENTS: For more information, please see the IRB “Guidance- Training and COI Requirements” in the IRBNet Forms and Templates. CONFLICT OF INTEREST (COI) DISCLOSURES: For more information, please see the IRB “Guidance- Training and COI Requirements” in the IRBNet Forms and Templates. TABLE OF STUDY STAFF: See section 1 of this application for instructions. If additional space is needed, please continue on a separate page using the same format. a. Name & degree b. Role(s) on Project. Examples: Principal Investigator, Coordinator, Consultant, Fellow, Resident, Student, Research Healthcare Operations only, Access to de-identified data only, Specimen shipment, etc. c. Place of employment d. Will this person be obtaining verbal or written Informed Consent/Authorization e. Is this person an “Investigator for the purposes of COI reporting”? THE PI IS ALWAYS CONSIDERED AN INVESTIGATOR FOR COI PURPOSES. For all other team members see section 2.e. above. f. Will this person aid the shipment of hazardous materials (e.g., dangerous goods, specimens) to be transported by a public carrier? SUNY Downstate KCHC Other: Yes No Yes No Yes No SUNY Downstate KCHC Other: Yes No Yes No Yes No SUNY Downstate KCHC Other: Yes No Yes No Yes No SUNY Downstate KCHC Other: Yes No Yes No Yes No SUNY Downstate KCHC Yes No Yes No Yes No SUNY Downstate KCHC Other: Yes No Yes No Yes No