IUPUI Institutional Biosafety Committee

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Indiana University
Institutional Biosafety Committee
STUDY AMENDMENT*
*To be used with the old IBC protocol form only (IUB).
Principal Investigator:
Department:
Email:
IBC Protocol #:
Originally Approved On:
Approved Biosafety Level:
Project Title:
Funding Agency(s):
VA Affiliated:
IBC Amendment #:
Perform a risk assessment per Section II-A-3 of the NIH Guidelines in order to determine the appropriate level of review by the IBC.
Submit all materials to your campus’ IBC:
IUPUI: [email protected]
IUB: [email protected]
Please note: This amendment form is required only for protocols submitted on the legacy protocol form. Amendments made to
protocols on the new protocol form (11/14) should be made directly on the protocol form (Sec. I-C-2).
MINOR AMENDMENT*:
MAJOR AMENDMENT**:
Adding/removing co-investigators (see required training)*
*please include IU email address in the description below
Adding new plant or animal species
Adding/changing/removing cell lines
Adding/changing transgene
Adding/changing/removing transgenic animals
Adding/changing infectious agents
IACUC study #:
Upgrade in containment level:
IACUC amendment #:
Adding/changing/removing laboratory room numbers:
Rooms being added:
Current Biosafety Level:
Proposed Biosafety Level:
Other
Rooms being removed:
Other
*Submit amendment form and any supporting documents. The
amendment will be considered by an IBC member for expedited
review.
**Submit signed amendment form, AND a signed
revised IBC Protocol Submission Form, and any
supporting documents. The amendment will be
considered in a convened meeting of the Biosafety
Committee.
Describe the proposed change(s) and rationale for the change(s):
Rev. 03/15
NOTE TO INVESTIGATORS: Study amendments may not be instituted until approval from the Institutional Biosafety Committee is
given. Retain this form for your records.
Investigator:
Date:
The amendment of this project has been reviewed and approved by the IUPUI Institutional Biosafety Committee.
Authorized
IBC Member:
Date:
IBC Office:
Date:
Final Approval
Rev. 03/15
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