QUESTION 3.9 Has any organisation/company participating in the research or funding the YES NO project, imposed any conditions to the research? If yes, please indicate what the conditions are. QUESTION 3.10 Does the proposed study involve collaborative, multi-institutional or multi-country research? (Please see paragraph 6 of the Policy on Research Ethics of The Da Vinci Institute and make sure that the principal researcher complies with the stipulations of the policy) Research in 1 country only Please state country: Research in more than 1 Please state countries: country Research to be conducted in Details: 1 institution ** Research is Please give details: ** ** In certain cases, consent is required from the institutions where the research will be undertaken (such as a hospital, clinic or school) and the relevant national, provincial and local health or educational authorities. In some of these cases, however, ethical clearance in Da Vinci is a for these institutions and/or authorities prior to considering the request for access student’s to the research site. SECTION 4: FORMALISATION OF THE APPLICATION APPLICANT AND SUPERVISOR I have familiarised myself with the Da Vinci Research Ethics Policy and undertake to Institute’s comply with it. The information supplied above is correct to the best of my knowledge. NB: PLEASE ENSURE THAT THE ATTACHED CHECK SHEET IS COMPLETED
QUESTION 3.9 Has any organisation/company participating in the research or funding the project, imposed any conditions to the research? YES NO If yes, please indicate what the conditions are. QUESTION 3.10 Does the proposed study involve collaborative, multi-institutional or multi-country research? (Please see paragraph 6 of the Policy on Research Ethics of The Da Vinci Institute and make sure that the principal researcher complies with the stipulations of the policy) Research in 1 country only Please state country: Research in more than 1 country Please state countries: Research to be conducted in 1 institution ** Details: Research is ** Please give details: ** In certain cases, consent is required from the institutions where the research will be undertaken (such as a hospital, clinic or school) and the relevant national, provincial and local health or educational authorities. In some of these cases, however, ethical clearance in Da Vinci is a for these institutions and/or authorities prior to considering the student’s request for access to the research site. SECTION 4: FORMALISATION OF THE APPLICATION APPLICANT AND SUPERVISOR I have familiarised myself with the Da Vinci Institute’s Research Ethics Policy and undertake to comply with it. The information supplied above is correct to the best of my knowledge. NB: PLEASE ENSURE THAT THE ATTACHED CHECK SHEET IS COMPLETED
Ethical-clearance-application-form-Da-Vinci-Institute-August-2018.docx