Submission for Document Acknowledgement Form (47.7 KB)

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HUMAN RESEARCH ETHICS COMMITTEE
(TASMANIA) NETWORK
SUBMISSION FOR DOCUMENT ACKNOWLEDGEMENT
HEALTH AND MEDICAL HREC
An electronic copy of documentation along with this form to be emailed to
[email protected]
This form should be completed for all types of Health and Medical documents that require
acknowledgment by the Ethics office which do not require committee review.
Ethics
Reference
Number
H
Date:
TITLE of Approved Project (Title used on the NEAF)
INVESTIGATOR NAMES
Chief Investigator
Phone:
Email:
Data Manager:
Phone:
Email:
DOCUMENTS SUBMITTED FOR ACKNOWLEDGEMENT
Please include version numbers where appropriate.
Document examples: Investigator brochures, Insurance Certificates, File Notes
Signatures:
Study Personnel or Investigator
Signature:
Date:
Version 2 May 2014
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