b) Is there any conflict of interest (including financial gain) likely to result YES NO from this project? If you answered please provide details and attach documentation. “YES” Organisations other than UNSW Are there organisations other than UNSW involved in this research (for example, organisations providing research site access and/or providing YES NO permission to gain access to staff and/or records)? If you answered please provide details and please attach a letter of support for the research “YES”, from each organisation involved. Declaration of Investigators I/we apply for approval to conduct the research. If approval is granted, it will be undertaken in accordance with the protocol described in this application and other relevant guidelines, regulations and laws. I have read the relevant section of the “National Statement on Ethical Conduct in Human Research” as enclosed on the homepage of the ASB Human Yes No Research Ethics or on the UNSW website. Note: Applicants must have read the relevant sections In my opinion, this research project complies with the on Ethical Conduct in Yes No “National Statement Human Research”. Name (Block Letters) Signature Date First Investigator: Co-Investigator: Supervisor (if applicable)
b) Is there any conflict of interest (including financial gain) likely to result from this project? YES NO If you answered “YES” please provide details and attach documentation. Organisations other than UNSW Are there organisations other than UNSW involved in this research (for example, organisations providing research site access and/or providing permission to gain access to staff and/or records)? YES NO If you answered “YES”, please provide details and please attach a letter of support for the research from each organisation involved. Declaration of Investigators I/we apply for approval to conduct the research. If approval is granted, it will be undertaken in accordance with the protocol described in this application and other relevant guidelines, regulations and laws. I have read the relevant section of the “National Statement on Ethical Conduct in Human Research” as enclosed on the homepage of the ASB Human Research Ethics or on the UNSW website. Note: Applicants must have read the relevant sections Yes No In my opinion, this research project complies with the “National Statement on Ethical Conduct in Human Research”. Yes No Name (Block Letters) Signature Date First Investigator: Co-Investigator: Supervisor (if applicable)
Human-Research-Ethics-application-form.docx