Complete the table below. (LR: Lead Researcher, FS: Faculty Sponsor, CR: Co-Researcher, RP: Research Personnel) Include additional rows for study team members as needed. If there is a Faculty Sponsor, s/he must be listed below (even if s/he is not engaged in research), as s/he must be identified to provide oversight and guidance to the Lead Researcher. Indicate whether the study team member will be involved in the following research activities. Personnel who are not interacting with participants for research purposes and/or who do not have access to identifiable private information or identifiable biospecimens (e.g., statisticians) are not engaged in human-subjects research and therefore should not be listed below. Department & Access Analyze UCI Affiliation Informed Interact Participant Participant - Faculty, Recruit Consent with Identifiable Identifiable Name, Title & Role Staff, Degrees Process Participant Information / Information / Graduate or Biospecimen Biospecimen Student N/A N/A N/A N/A N/A <Type LR <Type here> Yes Yes Yes Yes Yes here> No No No No No N/A N/A N/A N/A N/A <Type <Type here> FS Yes Yes Yes Yes Yes here> No No No No No N/A N/A N/A N/A N/A <Type CR <Type here> Yes Yes Yes Yes Yes RP here> No No No No No N/A N/A N/A N/A N/A <Type CR <Type here> Yes Yes Yes Yes Yes RP here> No No No No No N/A N/A N/A N/A N/A <Type CR <Type here> Yes Yes Yes Yes Yes RP here> No No No No No N/A N/A N/A N/A N/A <Type CR <Type here> Yes Yes Yes Yes Yes here> RP No No No No No SECTION 3: WHAT IS YOUR RESEARCH QUESTION? State the hypothesis or primary objective of the research. Include a rationale for conducting the study. [Maximum length = 250 WORDS] <Type here> SECTION 4: SUBJECT POPULATION Complete the table below. Include additional rows for subject category/group, as needed.
Complete the table below. (LR: Lead Researcher, FS: Faculty Sponsor, CR: Co-Researcher, RP: Research Personnel) Include additional rows for study team members as needed. If there is a Faculty Sponsor, s/he must be listed below (even if s/he is not engaged in research), as s/he must be identified to provide oversight and guidance to the Lead Researcher. Indicate whether the study team member will be involved in the following research activities. Personnel who are not interacting with participants for research purposes and/or who do not have access to identifiable private information or identifiable biospecimens (e.g., statisticians) are not engaged in human-subjects research and therefore should not be listed below. Role Name, Title & Degrees Department & UCI Affiliation - Faculty, Staff, Graduate or Student Recruit Informed Consent Process Interact with Participant Access Participant Identifiable Information / Biospecimen Analyze Participant Identifiable Information / Biospecimen LR <Type here> <Type here> N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No FS <Type here> <Type here> N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No CR RP <Type here> <Type here> N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No CR RP <Type here> <Type here> N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No CR RP <Type here> <Type here> N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No CR RP <Type here> <Type here> N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No SECTION 3: WHAT IS YOUR RESEARCH QUESTION? State the hypothesis or primary objective of the research. Include a rationale for conducting the study. [Maximum length = 250 WORDS] <Type here> SECTION 4: SUBJECT POPULATION Complete the table below. Include additional rows for subject category/group, as needed.
exempt-self-determination-tool.docx