Institutional Review Board Checklist

Complete the information as required, check the appropriate boxes, and then print the form using your browser. One form needs to be submitted for EACH research project involving human subjects. Attach this form to the other materials reauired for submission. If you have any questions, click here.

Title of Proposed Research

Date of Submission Principle Investigator

Additional Investigator Please Check: faculty student other

Additional Investigator Please Check: faculty student other

Additional Investigator Please Check: faculty student other

  1. Please check the appropriate box 

    2. This is a FIRST-TIME submission.

    This is a REVISION.

    This is a NOTICE OF CONTINUATION

2. Please check the review type this proposal needs, from your point of view.

Exempt (Please attach documentation how this proposal meets the criteria set forth in Section V.A. of the Augustana College Human Participants in Research Policy)

Expedited Review (Please attach documentation how this proposal meets the criteria set forth in Section V.B. of the Augustana College Human Participants in Research Policy)

Full Review

 

 

For all submissions, please attach the following documentation ------------

  1. an outline of research procedures (in sufficient detail to permit replication)
  2. a description of participants (number, how obtained, and anything else you consider pertinent)
  3. a brief explanation of how the benefits of your study outweigh whatever risk, deception, or lack of anonymity that is involved
  4. Informed Consent Forms, Letters to Participants, Questionnaires and Any Other Document Filled out by Participants