UNIVERSITY OF HARTFORD
HUMAN SUBJECTS COMMITTEE
RESEARCH PROJECT EXTENSION/CLOSURE REQUEST
You were either the principal investigator or one of the principal investigators on the following
research project that was approved by the University of Hartford Human Subjects Committee:
HSC Proposal
Number:
Project Title:
Approval Date:
PI Name:
………………………………………………………………………………….
According to our files, this project is either due to be continued or to be declared
complete. We therefore ask that you choose from among the following options:
1. I have officially concluded collecting and analyzing all human subject data on
this project, and declare it complete.
Data collected for this project has been handled in the following manner:
All documents linking personal identifiers of participants to their data have been
destroyed.
All data containing personal identifiers of participants is being securely stored
and protected in the manner described in the original protocol for this research
project.
………………………………………………………………………………….
2. Data collection for this study is complete, but I am continuing to analyze
data from this study.
All documents linking personal identifiers of participants to their data have been
destroyed.
All data containing personal identifiers of participants is being securely stored
and protected in the manner described in the original protocol for this research
project. I am requesting continuation of research on this project, for a period of
no longer than 12 months. There are no changes of any kind to the study project
protocols, as they were originally approved by the University of Hartford Human
Subjects Committee at the project’s inception or the most recent modification.
………………………………………………………………………………….
3. I am still collecting data for this study, which is being securely stored and
protected in the manner described in the original protocol for this research project.
I am requesting continuation of research on this project, for a period of no longer than
12 months. **There are no changes of any kind to the study project protocols,
as they were originally approved by the University of Hartford Human Subjects
Committee at the project’s inception or the most recent modification requested.
Please answer the 5 research review questions on the next page.
**If you wish to make any modifications to your current proposal, please be sure to
submit the appropriate modification request form, available on the HSC Web site.
UNIVERSITY OF HARTFORD
HUMAN SUBJECTS COMMITTEE
Research Review Questions (for continuing projects only):
1. When do you anticipate completing this research?
2. Now that you have been doing this research for a year, please reassess the risks (physical,
psychological, financial, social, legal, etc.) posed to participants. Are the actual risks and benefits
to your participants as anticipated?
3. Have there been any adverse events (anticipated or unanticipated), since the last review? If
yes, please describe below. (Please remember that all adverse events must be reported using the
“Adverse Event Reporting Form” available on the HSC web site)
4. How many participants have withdrawn from your research, and why?
5. Attach a copy of your current Consent Form, even if we have the form on file. We want to be
sure that the information you provide about informed consent is up to date with current HSC
standards.
………………………………………………………………………………….
Your signature below indicates that you have read and understood the information provided
above.
Signature of Principal Investigator:
Name of Investigator (PLEASE PRINT):
Date:
PLEASE RETURN THIS SIGNED & COMPLETED FORM TO UNIVERSITY OF HARTFORD HUMAN
SUBJECTS COMMITTEE AT DANA HALL 401C OR SCAN AND EMAIL TO HSC@HARTFORD.EDU
………………………………………………………………………………….
HSC USE ONLY
Signature of Chair, Human Subjects Committee: ____________________________________
Date Received from PI: ____________________
Date Approved: _______________________