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University of Illinois Urbana-Champaign (UIUC)
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Section 1: Study Title
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1.1) Title of Study
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1.2) Study Purposes and Objectives
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1.3) Background and Introduction
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1.4) Was this project previously ap...
Section 2: Research Team
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2.1) Principal Investigator Name
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Principal Investigator Email
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Principal Investigator Department
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2.2) Select the Position of the Pri...
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2.3) Is this a student-led research...
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Student's Name (if applicable)
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2.4) Are two or more members of the...
Section 3: Funding
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3.1) Is the research funded?
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3.2) Add any funding sources you ha...
Section 4: Subjects
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4.1) Ages of Subjects
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4.2) Specific age range of subjects
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4.3) Indicate any vulnerable popula...
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4.4) Has the participant selection ...
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4.5.1) Total Subjects enrolled by U...
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4.5.2) Total Subjects enrolled by a...
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4.6) Participant Inclusion Criteria
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4.7) Participant Exclusion Criteria
Section 5: Vulnerable Populations
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5.1) How does the nature of the res...
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5.2) Would it be possible to conduc...
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5.3) Is this population being inclu...
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5.4) Does the scientific merit of t...
Section 6: Study Information
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6.1) Non-Experimental and/or Descri...
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6.2) Experimental and/or Interventi...
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6.3) This project is Community Base...
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6.4) Study includes creating resear...
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6.5) Study will include a research ...
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6.6) Length of entire study from in...
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6.7) Length of individual subject's...
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6.8) How will subjects be recruited...
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6.9) Describe the recruitment/parti...
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6.10) How will consent be obtained?
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6.11) Describe all procedures chron...
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6.12) Are all procedures for resear...
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6.13) Provide a summary of the stat...
Section 7: Consent Process
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7.1) Describe the location(s) where...
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7.2) Describe whether there is a wa...
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7.3) Describe what measures will be...
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7.4) Describe the provisions that a...
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7.5) Will a legally authorized repr...
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7.7) Will a language other than Eng...
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7.10) Are you requesting that docum...
Section 9: Data Monitoring
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9.1) Privacy Protections – What pre...
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9.2) Confidentiality Precautions – ...
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9.3) Will photos, audio recording, ...
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If yes, describe the recording/imag...
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9.4) How will study data and docume...
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9.5) Who will be the primary monito...
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9.6) How often is study data and do...
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9.7) Is there a SAFETY monitoring p...
Section 10: Risks and Benefits
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10.1) Describe the reasonable fores...
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10.2) Describe the potential direct...
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10.3) Describe the potential benefi...
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10.4) Using lay language, please de...
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10.5) Are there any costs to the su...
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10.6) Is there any compensation to ...
Section 12: Resources and Responsibilities
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12.1) State and justify the qualifi...
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12.2) Describe the training that st...
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12.3) Describe the facilities where...
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12.4) Describe the medical or psych...
Section 13: Additional Information
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13.1) Does this study involve any o...
Section 16: Databases and Repositories
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16.1) Select the items that will be...
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16.2) What type(s) of future resear...
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16.3) Who manages the repository an...
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16.4) Indicate whether the data/sam...
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16.6.1) Describe the process for de...
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16.7) Describe the procedures for p...
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16.8) Will future results or findin...
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16.9) Describe the procedures for o...
Section 21: Devices
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21.1) Name of device, algorithm, or...
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Please describe the device, algorit...
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Is this device generally considered...
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What is the initial risk determinat...
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Provide justification of why the me...
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