A. Protocol Information Title of Protocol IRB protocol number* be assigned upon submission *will B. Principal Investigator (PI) Name Degree/Title Dept. & College at RFUMS Email Phone Most recent CITI training* C. If this is a postdoctoral or student project (supervised and sponsored by the faculty PI) provide name of the trainee: D. List all members of the research team (add rows as needed): RFUMS Dept. & Date of College; Role in Name & Title Email recent CITI project Work Address (if training* non-RFUMS) * Include pdfs of all training certificates with application E. Funding information Federal funding agency (direct grant award) Federal flow-through funds (subcontract/collaborator) Non-federal grant or sponsor Other None External funding agency/sponsor information including Grant or Sponsor’s Project ID number: Part II: Self-Assessment of Exemption Criteria Even though the IRB may determine that some research is exempt from continuing review per federal regulations, adequate provisions still need to be in place to protect research participants. In making its consideration of exempt status, the IRB asks that the PI provide a self-assessment that this research project qualifies for exempt status. The IRB must agree with this assessment and also must determine that: a) The research involves no more than minimal risk to participants. b) Selection of participants is equitable.
A. Protocol Information Title of Protocol IRB protocol number* *will be assigned upon submission B. Principal Investigator (PI) Name Degree/Title Dept. & College at RFUMS Email Phone Most recent CITI training* C. If this is a postdoctoral or student project (supervised and sponsored by the faculty PI) provide name of the trainee: D. List all members of the research team (add rows as needed): Name & Title Email RFUMS Dept. & College; Work Address (if non-RFUMS) Role in project Date of recent CITI training* * Include pdfs of all training certificates with application E. Funding information Federal funding agency (direct grant award) Federal flow-through funds (subcontract/collaborator) Non-federal grant or sponsor Other None External funding agency/sponsor information including Grant or Sponsor’s Project ID number: Part II: Self-Assessment of Exemption Criteria Even though the IRB may determine that some research is exempt from continuing review per federal regulations, adequate provisions still need to be in place to protect research participants. In making its consideration of exempt status, the IRB asks that the PI provide a self-assessment that this research project qualifies for exempt status. The IRB must agree with this assessment and also must determine that: a) The research involves no more than minimal risk to participants. b) Selection of participants is equitable.
exempt-protocol-irb-application-form.docx