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Continuing Review Application

Send to IRB Office, Mail: 5037, 2115 Summit Ave., St. Paul, MN  55105

 

 

1.  Primary Investigator:                                                                                                    

2.  Title and IRB number of Research:                                                                           

3.   ____  Faculty/Staff____  Graduate Student    ____  Undergraduate ____  Other

 

4a. Date of last IRB approval:                       4b.Level of review :   exempt/expedited/full

 

5.  Address:                                                  

                                                                       

                                                                       

6.  Phone:                                                     

7.  Email:                                                      

 

8.  Are you still gathering or analyzing data on this research?

 

9. How many subjects have you enrolled in this research since your last review?

 

10. Since your last IRB review, have there been any problems or advance events which have arisen as a result
      of  the research? If so, please explain.

 

11. Since your last IRB review, have you modified your protocol in such any way?  If yes, please explain the
      modification and the steps you have taken to minimize risk to subjects.

 

12. Since your last IRB review, have you modified your consent form in any way?  If so, please explain the modification and the steps you have taken to insure that subject participation is voluntary and the confidentiality of subject participation.

 

 

Signature:                                                                     Date:                                              

 

 

Please enclose a copy of your consent form.