IRB RESEARCH PROPOSAL FORM
For Research Projects Involving Human Participants
GENERAL INFORMATION
I am either the original Principal Investigator or another Principal Investigator (PI) on the following project previously approved by the Institutional Review Board (IRB) of Wesleyan University. I am requesting approval for a change of protocol.
Project title:
IRB project label:
Project label is also the name of the WesFiles folder created to submit the original proposal.
Current date:
Principal Investigator:
Email:
Phone:
Faculty/Staff Advisor:
Advisor email:
Advisor name required for student submissions.
PROPOSED CHANGES TO RESEARCH PROTOCOL
I am making changes to the study project protocols as they were originally approved by the IRB of Wesleyan
University or approved in a previous change of protocol. These changes are as follows:
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IRB RESEARCH PROPOSAL FORM
ELECTRONIC SIGNATURES
As a Principal Investigator, I understand that these proposed changes will be reviewed by the IRB of Wesleyan
University and that the changes cannot be implemented until they have been fully approved. My name typed below serves as my acceptance of this statement and of the contents of this document.
Principal Investigator:
As Faculty Advisor (if applicable), my name typed below serves as my approval of the changes proposed in this document. (Student proposals will not be accepted unless accompanied by a faculty acknowledgement.)
Faculty Advisor:
See instructions at www.wesleyan.edu/IRB for how to submit this document. Please be sure to put this document in the same folder as that containing the original proposal. Contact the IRB Administrative
Coordinator if you have any difficulty submitting materials.
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