Request for Changes to a Cleared Research Protocol

Involving Human Participants

Please direct all questions regarding the completion of this form to an Ethics Coordinator in the Carleton University Research Compliance Office at:

1  ADMINISTRATIVE CHANGES

1.1  Do you propose changing the title of the project? Yes No;

1.1.1  If Yes: Please provide the new title and copies of all documentation (Letter of Information, Consent From, etc.) with the revised title.

Original title
New title

1.2  Has your research supervisor changed? Yes No N/A

Original supervisor
New supervisor

1.3  Have new team members been added or removed from the project? Yes No;

1.3.1  If Yes: Please provide the name, department and contact information of the new researchers and submit copies of all documentation with the revised information.

NAME / EMPLOYEE/STUDENT ID NUMBER / DEPARTMENT / CARLETON EMAIL

1.4  Provide the name of person(s) that are being removed.

2  METHODOLOGY

2.1  Are you proposing changes to the methodology or project design? Yes No;

2.1.1  If Yes: Please provide details of the changes

3  RESEARCH PARTICIPANTS

3.1  Do you propose changing the participant group selected for the project? Yes No;

3.1.1  If Yes: Please describe the participants and any inclusion criteria (e.g. indicate details such as age group, gender, language, race, ethnicity, and medical conditions. If applicable, describe any exclusion criteria. Please also describe any control groups employed in the study. Provide a justification for the changes and copies of all revised documents.

4  RECRUITMENT

4.1  Do you propose changing the means of participant recruitment for the project? Yes No;

4.1.1  If Yes: Please provide details of the changes and copies of all revised documents.

5  RESEARCH INSTRUMENT

5.1  Do you propose changes to questionnaire, survey, interview questions/themes or other research instrument? Yes No;

5.1.1  If Yes: Please provide details of the changes and revised copies of all documents.

6  PROJECT RECRUITMENT AND CONSENT DOCUMENTS

6.1  Do you propose changing the project documents for recruitment? Yes No;

6.1.1  If Yes: Please provide details of the changes and copies of all revised documents.

6.2  Do you propose changing the project documents for consent? Yes No;

6.2.1  If Yes: Please provide details of the changes and copies of all revised documents.

7  EXTERNAL REB

7.1  Are you proposing changes because of an external REB review? Yes No;

7.1.1  If Yes: Please provide a copy of the correspondence from the external REB, details of the changes and copies of all revised documents.

8  OTHER CHANGES

8.1  Please include details of other changes to your project not covered in this form.

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Last Modified: April 4, 2016