Request for Amendment / Addendum to Approved REC Protocol

Request for Amendment / Addendum to Approved REC Protocol

Research Ethics Committee
Please use this form to request an amendment/addendum to a currently approved Spalding REC protocol. This includes any change in a study's design, personnel or participant population.

Note: All amendment/addendum requests must be submitted no later than 30 days prior to the expiration of your originally approved protocol. If you are past that date, you must submit a new proposal.
Is this your initial amendment request or response to conditions?*

InitialRevised
Name of principle investigator (PI) / faculty advisor on project*
PI / Faculty Advisor Email*
example@example.com
Name of student /co investigator*
Title of Approved Proposal*
REC Proposal Number*
Approval Expiration Date*

MonthDayYear
Date
Type of Initial Review Conducted:*

Full BoardExpeditedExempt
Please provide a short summary of the changes you are requesting. *
Please provide justification for the proposed change(s) (i.e. why the changes are needed). How will the proposed change(s)/improve the study? *
Please upload your previously approved proposal with the proposed changes highlighted. Be sure to revise and attach all relevant documents to reflect the proposed changes and highlight any and all changes made in each document (i.e. recruitment scripts, consent forms, etc.)

Cancelof
Are you adding or changing project personnel?

YESNO
If you selected YES, have all new research personnel submitted certificates of completion for the required CITI training? (note the training must be completed every 3 years)

YESNO
Name of individual submitting request*
Project Role*
Email*
example@example.com
Signature of Individual Submitting Request*

Clear
Date

MonthDayYear
Date
Principal Investigator / Faculty Advisor Signature

Clear
Date

MonthDayYear
Date