Data from a NYC School Yes No TABLE OF STUDY STAFF: For training and conflict of interest disclosure requirements see: a. b. c. d. e. f. Name & degree Role(s) on Project. Place of employment Will this person be Is this person an Will this person aid Examples: Principal REMINDER: is also obtaining verbal or for the “Investigator the shipment of Investigator, required for all NYC H+H written Informed purposes of COI hazardous materials Coordinator, research. Consent/Authorization reporting”? (e.g., dangerous Consultant, Fellow, goods, specimens) to Resident, Student, be transported by a THE PI IS ALWAYS Research Healthcare public carrier? CONSIDERED AN Operations only, Access to INVESTIGATOR FOR de-identified data only, COI PURPOSES. Specimen shipment, etc. SUNY Downstate Yes No Yes No Yes No NYC +HH, KC Other: SUNY Downstate Yes No Yes No Yes No NYC +HH, KC Other: SUNY Downstate Yes No Yes No Yes No NYC +HH, KC Other: SUNY Downstate Yes No Yes No Yes No NYC +HH, KC Other: SUNY Downstate Yes No Yes No Yes No NYC +HH, KC Other: SUNY Downstate Yes No Yes No Yes No NYC +HH, KC Other: SUNY Downstate Yes No Yes No Yes No NYC +HH, KC Other:
Data from a NYC School Yes No TABLE OF STUDY STAFF: For training and conflict of interest disclosure requirements see: a. Name & degree b. Role(s) on Project. Examples: Principal Investigator, Coordinator, Consultant, Fellow, Resident, Student, Research Healthcare Operations only, Access to de-identified data only, Specimen shipment, etc. c. Place of employment REMINDER: is also required for all NYC H+H research. d. Will this person be obtaining verbal or written Informed Consent/Authorization e. Is this person an “Investigator for the purposes of COI reporting”? THE PI IS ALWAYS CONSIDERED AN INVESTIGATOR FOR COI PURPOSES. f. Will this person aid the shipment of hazardous materials (e.g., dangerous goods, specimens) to be transported by a public carrier? SUNY Downstate NYC +HH, KC Other: Yes No Yes No Yes No SUNY Downstate NYC +HH, KC Other: Yes No Yes No Yes No SUNY Downstate NYC +HH, KC Other: Yes No Yes No Yes No SUNY Downstate NYC +HH, KC Other: Yes No Yes No Yes No SUNY Downstate NYC +HH, KC Other: Yes No Yes No Yes No SUNY Downstate NYC +HH, KC Other: Yes No Yes No Yes No SUNY Downstate NYC +HH, KC Other: Yes No Yes No Yes No
ApplicationforExternalIRBOversightplusGuidance07182017.docx