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 human.ethics@utas.edu.au 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 Page 1 of 1