St. John Fisher University Institutional Review Board

Project Continuation and/or Modification

Continuation is good for one year; each project can be granted up to 2 continuations. A modification approval within the original timeline of the project does not change the approval termination date.

Instructions:

Please combine this form and any attachments into one Word or PDF document.

If student is the principal investigator, the form requires faculty supervisor’s signature.

SECTION ONE: SUMMARY INFORMATION

Provide information about your project.

Principal Investigator:
Project Number:
Project Title:
Email:
Status:	☐ Undergraduate Student ☐ Graduate Student ☐ Faculty/Staff
Faculty Supervisor (if applicable):
Research Category:	☐ Exempt ☐ Expedited ☐ Full Board Review
Request:	☐Continuation only ☐Continuation with modification(s) ☐Modification(s) only

SECTION TWO: CONTINUATION REQUEST

Number of subjects participating in this research to date:

Have there been any adverse events or unanticipated problems involving risks to subjects or others? ☐Yes	☐No

If yes, explain:

Has there been any withdrawal of subjects from the research due to concerns or complaints about the research? ☐Yes	☐No

If yes, explain:

Have there been any problems, complaints or withdrawals due to deception (if applicable)? ☐Yes	☐No

If yes, explain:

Has there been any new literature or new information about any potential risks associated with the project? ☐Yes	☐No

If yes, explain:

Provide a 1-2 paragraph summary of research findings from the previous year (if applicable):

Provide any other pertinent information below:

SECTION THREE: MODIFICATION REQUEST

Indicate the type of modification(s) and provide specific details about each.

☐Number, age, or description of subjects.

☐Recruitment procedures or materials.

☐Consent procedures or materials

☐Location

☐Instruments, including survey forms, interview questions or tests

☐Other

Attach any new materials in the appendix of this document. If modifying an existing document, highlight revisions within the document.

SECTION FOUR: STUDENTS ONLY

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Faculty Research Advisor signature