HRPC Site Continuing Review Report
Date
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Sponsor Name:
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Indicate the name of the Principal Investigator for whom you are submitting this form
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Research Status
☐Indicate the status of the research study:
☐Active, NO subjects have been accrued
☐Active, subjects have been accrued
☐Enrollment is closed and site is still open
☐Enrollment is closed and site is closed
Provide the current HRPC approval date on the main consent document:Click or tap here to enter text.
Provide the most recent date that a subject signed the main consent documentClick or tap here to enter text.
Number of subjects enrolled since study startup:Click or tap here to enter text.
(A subject is enrolled if the subject or representative gave consent to participate in the research. For protocols with a waiver of consent, a subject is enrolled if included in the research.)
Of the number of subjects enrolled, how many failed screening?Click or tap here to enter text.
(Enter 0 if the protocol does not involve screening or interventions)
Provide the number of subjects who withdrew from the research or were withdrawn/discontinued: Click or tap here to enter text.
(A subject is considered to have been withdrawn/discontinued from the research when the subject either stopped participation or the research team stopped the subject’s participation early for reason other than reaching a study endpoint. Do not count screen failures.)
Provide the number of subject who complete the research: Click or tap here to enter text.
(A subject is considered to have completed the research when the subject wither completed all research procedures or completed all research procedures up to a study endpoint.)
Please type name of individual completing form: Click or tap here to enter text.