Revised 5/29/2016
IRB Completion Report
Prairie View A&M University
IRB USE ONLY
Last Name ____________
IRB #: ______________
IRB#:
Project Title:
Initial Approval Date:
Date Study and Data Analysis Completed:
Investigator Information
Principal Investigator Name:
Phone
Email
Graduate Committee Chair/Faculty Advisor Name (if student):
Phone
Email
Total Participants Approved:
Total Participants Currently Utilized:
No Participants
Reason for No Participants:
Were there any unanticipated or adverse events?
Yes
If yes, complete and attach the unanticipated event report form.
No
Document Retention
Federal law requires that documents be retained for THREE years following the COMPLETION of the
study. (Note - some funding agencies, journals require longer retention).
Page 1 of 2
PVAMU IRB – Completion Report – E-mail research@pvamu.edu or call (936) 261-1553 with any questions regarding this form.
Revised 5/29/2016
Reporting of Findings
Federal law requires that IF a study results in information that is BENEFICIAL to the participant that
the participants be informed.
Were there any findings that would be BENEFICIAL to the participant?
Yes
No
1. What were those findings?
2. How were participants informed of those findings? Include copies of letters sent to participants,
etc.
The research was complete in a satisfactory manner and was unchanged from the
previously approved protocol.
Principal Investigator (please use blue ink)
Signature: ______________________________________________________ Date: ______________
Typed Name:
Page 2 of 2
PVAMU IRB – Completion Report – E-mail research@pvamu.edu or call (936) 261-1553 with any questions regarding this form.