Human Research Ethics Office Research Services, MBDP: M459 The University of Western Australia 35 Stirling Highway Crawley WA 6009 +61 8 6488 4703 Fax: +61 8 6488 8775 Email: research.uwa.edu.au/staff/human-research Application for Human Research Ethics Review Use this form to apply for ethical review of research involving people to be carried out at The University of Western Australia. Ethical review of research is a necessary pre-requisite for research involving humans at the University. This includes research that studies data about people and observation of people. Email the completed form to Human Research Ethics Office: Email or phone the office for assistance with this form contact details are in the letterhead above. – UWA reference no. RA/4/1/ Office use, TRIM # Project title: Trial Investigator, or Supervisor in case of student research: Name Title, given name, and family name School, Centre or Faculty StaffId #: Telephone Email: Additional researchers / co-investigators, including students and non-UWA investigators Researcher given name, and family 2 School, centre, institution Staff # or student # Co-inv, student, … name Researcher 3 Title, given name, and family name School, centre, institution Staff # or student # Co-inv, student, … Researcher given name, and family 4 School, centre, institution Staff # or student # Co-inv, student, … name Researcher given name, and family 5 School, centre, institution Staff # or student # Co-inv, student, … name [Additional investigators can be noted in the comments section near the end] Team Expertise (clinical research) , Explain how the research team has sufficient skills and experience to conduct the proposed clinical research.
Human Research Ethics Office Research Services, MBDP: M459 The University of Western Australia 35 Stirling Highway Crawley WA 6009 +61 8 6488 4703 Fax: +61 8 6488 8775 Email: research.uwa.edu.au/staff/human-research Application for Human Research Ethics Review Use this form to apply for ethical review of research involving people to be carried out at The University of Western Australia. Ethical review of research is a necessary pre-requisite for research involving humans at the University. This includes research that studies data about people and observation of people. Email the completed form to Human Research Ethics Office: Email or phone the office for assistance with this form – contact details are in the letterhead above. UWA reference no. Office use, TRIM # RA/4/1/ Project title: Investigator, or Supervisor in case of student research: Name Title, given name, and family name School, Centre or Faculty StaffId #: Telephone Email: Additional researchers / co-investigators, including students and non-UWA investigators Researcher 2 given name, and family name School, centre, institution Staff # or student # Co-inv, student, … Researcher 3 Title, given name, and family name School, centre, institution Staff # or student # Co-inv, student, … Researcher 4 given name, and family name School, centre, institution Staff # or student # Co-inv, student, … Researcher 5 given name, and family name School, centre, institution Staff # or student # Co-inv, student, … [Additional investigators can be noted in the comments section near the end] Team Expertise (clinical research) , Explain how the research team has sufficient skills and experience to conduct the proposed clinical research. Trial
HRE-Application-V9.docx