Tulane University
Institutional Biosafety Committee (IBC)
Request for Amendment to Approved Protocol
Principal Investigators (PIs) must submit this form to request changes or modification to a previously
approved IBC protocol. It is the responsibility of the PI to notify the IBC of changes to an approved
protocol. The original protocol approval will expire at the previously approved expiration date (original 3 or
2 year approval). It is recommended that the IBC Chair be consulted in advance of filling out this form as
some changes may require submittal of a new protocol or additional information. Send this form by e-mail
to ibc@tulane.edu
Approved IBC protocol Number:
Date of approval:
Protocol title:
Principal Investigator:
Department :
Telephone :
E-mail
School:
Check the items that differ from your last application:
Project title
Location of Project :
Biosafety level
New personnel:
Use of Recombinant DNA
Type of Infectious agents
Use of other biological reagents (blood, body fluids, cell lines):
Use of transgenic plants or animals
Use of Select Agents or toxins
Other
Provide details of the intended changes. The IBC will determine if your proposed changes can be done
via an amendment or require submission of a new protocol (add additional pages if necessary)
Signature of PI:____________________________
Date:
Page 1 of 2
IBC Amendment Form- January 2010
For IBC use only:
Protocol number:
This amendment is: APPROVED :
Amendment number:
NOT APPROVED :
Signature of IBC: _________________________ __
Date:
Page 2 of 2
IBC Amendment Form- January 2010