Please print and sign the form below. The signed form must be submitted before your proposal may be reviewed by the IRB. Completed forms may be scanned and sent to irb@defiance.edu.
My signature on this form indicates that the above information is accurate. I understand that it is my responsibility to protect the rights and the welfare of my subjects. I will protect the confidentiality of the information provided by my subjects unless I have obtained their written permission to disclose this information to others.
Faculty advisor: As a faculty advisor I understand that it is my responsibility to insure that I and all students working on this project have received the training needed to conduct the study and to safeguard the wellbeing of the subjects with whom they will interact.
Signature of Principle Investigator _________________________________________________________________________
Date__________________________________________________________________________________________________
Signature of Faculty Advisor_______________________________________________________________________________
Date__________________________________________________________________________________________________
Please print this page, sign it, and email a scanned copy to irb@defiance.edu. Please keep a copy for your records.