IRB New Proposal Form

Section 1

Please enter the following information about yourself:
Today's date: Today's date: / MM / DD YYYY
Name: Name: First Last
Email:
Your Academic Program/Department/Office:
Your status (faculty, staff, graduate or undergraduate student):
Adviser or Faculty Sponsor (if applicable):
If you are a graduate or undergraduate student, has your Adviser or Faculty Sponsor seen and approved your application?

If you are a graduate or undergraduate student, has your Adviser or Faculty Sponsor seen and approved your application? Yes No
Your Adviser's or Faculty Sponsor's email address (if applicable):
Please list all individuals (full name and status, i.e. faculty, staff, student) involved in this project that will be working with human subjects. Note: Everyone listed must have completed Human Subject Research Training within the past three years.
Do you have external funding for this research?

Do you have external funding for this research? Yes No
If so, state the name of the sponsor and the title of the project as it was submitted to that sponsor.
Section 2

Please enter the following information about your project.
What is the title of your project?
When do you plan to begin this project? (Start date): When do you plan to begin this project? (Start date): / MM / DD YYYY
Describe your research project:
Describe the population(s) you plan to recruit and how you plan to recruit participants. Please submit all recruitment material, emails and scripts to [email protected]
Will your participants include individuals from vulnerable or protected populations (e.g., children, pregnant women, prisoners, or the cognitively impaired)?

Will your participants include individuals from vulnerable or protected populations (e.g., children, pregnant women, prisoners, or the cognitively impaired)? Yes no
If your participants will include individuals from the above populations, please specify the population(s) and describe any special precautions you will use to recruit and consent.
Approximately how many individuals do you expect to participate in your study?
Describe the procedures you will be using to conduct your research. Include descriptions of what tasks your participants will be asked to do, and about how much time will be expected of each individual. NOTE: If you have supporting materials (printed surveys, questionnaires, interview questions, etc.), email these documents separately as attachments to [email protected]. Name your attachments with your last name and a brief description (e.g., "WatsonSurvey.doc").
Describe any risks and/or benefits your research may have for your participants.
Describe how you plan to mitigate (if possible) any risks the participants may encounter.
Describe the consent process (i.e., how you will explain the consent form and the consent process to your participants):
Have you prepared a consent form(s) and emailed it as an attachment to [email protected]?
Note: You must submit all necessary consent forms before your proposal is considered complete.

Have you prepared a consent form(s) and emailed it as an attachment to [email protected]?
Note: You must submit all necessary consent forms before your proposal is considered complete. Yes No
If you are collecting data via media capture (video, audio, photos), have you included a section requesting consent for this procedure(s) in your consent form(s)?

If you are collecting data via media capture (video, audio, photos), have you included a section requesting consent for this procedure(s) in your consent form(s)? Yes No Not applicable
If your project will require you to employ a verbal consent process (no written consent forms), please describe why this process is necessary and how verbal consent will be obtained and stored.
What procedures will you use to ensure that the information your participants provide will remain confidential and safeguarded against improper access or dissemination?
Will it be necessary to use deception with your participants at any time during this research? Withholding details about the specifics of one's hypothesis does not constitute deception, this is called incomplete disclosure. Deception involves purposefully misleading participants about the nature of the research question or about the nature of the task they will be completing.

Will it be necessary to use deception with your participants at any time during this research? Withholding details about the specifics of one's hypothesis does not constitute deception, this is called incomplete disclosure. Deception involves purposefully misleading participants about the nature of the research question or about the nature of the task they will be completing. Yes No
If your project study includes deception, please describe here the process you will use, why the deception is necessary, and a full description of your debriefing procedures.
For all projects, please include your debriefing statement. (This is information you provide to the participant at the end of your study to explain your research question more fully than you may have been able to do at the beginning of the study.) All studies must include a debriefing statement. Be sure to give participants the opportunity to ask any additional questions they may have about the study.
If you will be conducting interviews in a language other than English, will you conduct all of the interviews yourself, or will you have the assistance of a translator? If you will be using the assistance of a translator, that individual must also certify that he or she is familiar with the human subject protocol and has completed the online training course.

If you will be conducting interviews in a language other than English, will you conduct all of the interviews yourself, or will you have the assistance of a translator? If you will be using the assistance of a translator, that individual must also certify that he or she is familiar with the human subject protocol and has completed the online training course. Myself Translator Not applicable
If your recruitment materials or consent forms will be presented in languages other than English, please translate these documents and email copies to [email protected]. I have submitted all of my translated materials.

If your recruitment materials or consent forms will be presented in languages other than English, please translate these documents and email copies to [email protected]. I have submitted all of my translated materials. Yes No Not applicable
Section 3

To finalize and submit your application. Please verify that you have completed this form fully and accurately.
Finalize and Submit

I agree to obtain IRB approval prior to beginning my work with human subject participants. I agree to only perform the research as described in the above application. I agree to seek IRB approval for any modifications in the approved study. I agree to inform the IRB if I receive any complaints from research participants within two days of receiving a compliant. I certify that all of the information contained in this proposal is accurate and truthful.

Submitting this form means that you affirm the statement above and will comply with the content. This counts as your legally binding signature

IRB New Proposal Form

IRB New Proposal Form

Section 1

Section 2

Section 3

Finalize and Submit