طلب مراجعة أخلاقيات البحث

بيانات أساسية ( الباحث الرئيس )

بيانات أساسية ( الباحثون ...

عنوان المقترح البحثي

Please tick boxes where appropriate and complete t

Participants

Consent and Participation

Research Project Proposal

X. Resumes

XI-Commitment

agreement

إرسال الطلبيمكنك الآن إرسال طلبك.

الإسم Name *

رقم الجوال - Mobile *

البريد الإلكتروني - Email *

الكلية / القسم College/Department *

الرتبة العلمية Academic Title *

الرقم الوظيفي Employee ID

تاريخ بداية المشروع desired starting date *

الإسم Name

الكلية / القسم College/Department

الرتبة العلمية Academic Title

رقم الهوية ID number

البريد الإلكتروني - Email

رقم الجوال - Mobile

باللغة العربية In Arabic *

باللغة الإنجليزية In English *

الجهة الداعمة للبحث Name of Sponsor

الميزانية Budget

المدة بالشهر Period *

Was this proposal sent to any other IRB *

Type of Research Project *

Subjects and Materials of Research *

Clinical Human Research *

? Does your project include children under 16 years of age *

Yes
No
N/A

?Does your project include people with learning or communication difficulties *

Yes
No
N/A

?Does your project include people belonging to a vulnerable group *

Yes
No
N/A

Will you tell participants that their participation is for research *

Will you obtain written consent for participation *

If the research is observational, will you ask participants for their consent to being observed *

Will you tell participants that they may withdraw at any time and for any reasons *

Will you give potential participants a significant time to consider participation *

Will you explain the main experimental procedures *

Will you tell participants that their data will be confidential *

Research Abstract *

(less than 300 words)

Litterature review and importance *

Objectives *

Materials & methods *

(...Management Plan (Describe Data monitoring, safety considerations, handling complications, samples disposal, hazardous material *

Criteria for inclusion and exclusion of subject and controls *

Time table for objectives

(Task (Period Month 1 to 24 to month 1 to 24
Start month
Finish month

Period Month 1 to 24 to month 1 to 24

Did you have any compensation in your research *

If " yes " kindly answer the following questions

Compensation to Investigators *

If yes, then

Mention the location of the study *

What are the actual potential benefits if any, to the participants and society *

Has this study conducted elsewhere earlier? If yes where *

Please give references

Principal Investigator *

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Co-investigator(s)

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Add consent form and questionnaire *

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Commitment *

I commit to attach a sample consent form for research study. Also I commit to provide photocopy of c

I agree to comply with the described proposal and inform the IRB for any changes to the protocol *

yes
no

تاريخ التقديم Date of the application *