Research Services, MBDP: M459
The University of Western Australia
35 Stirling Highway
Crawley WA 6009
Phone: +61 8 6488 4703
Fax: +61 8 6488 8775
Email:
research.uwa.edu.au/staff/human-research
Request to Re-open a Human Research Ethics Approval
Use this form to request to re-establish ethics approval for a suspended or closed project. No work with human participants can re-commence without human research ethics approval. If your project is closed or suspended you must not resume work until the approval to resume the project is granted.
Submit completed form to Human Research Ethics Office:
UWA reference no.
TRIM # / RA/4/ Click here to enter text.
1. Project title: / Click here to enter text.
2.
3. Chief Investigator, or Supervisor in case of student research:
Name / Click here to enter text.
Title, given name, and family name
Telephone / Click here to enter text. / Telephone / Click here to enter text.
4. Original
Approval Date: / Click here to enter a date. / 5. Date closed / suspended / Click here to enter a date.
6. / 7. Requested End Date: / Click here to enter a date.
8.
9. Reason for requesting resumption / Click here to enter text.
10.
11. Project completion program: / Click here to enter text.
Provide a clear completion program for the project, including specific program tasks and a time schedule for completion.
12.
13. Will there be any changes to the original project? / Click here to enter text.
If yes, you will also need to submit an amendment application to this office.
14.
15. Additional information or comments: / Click here to enter text.
Certification / signatures
Chief Investigatoror Supervisor of Higher Degree Research Student: / Declaration by the Chief Investigator
· I accept legal and ethical responsibility for the conduct of this project.
· I confirm that research activities will not re-commence until approval has been granted to re-open the project.
· I confirm that, if the project is re-opened, research activities will be conducted in compliance with the terms of the original ethics approval for the project, and (if approved) any changed terms of ethics approval for project modifications that have been requested in this form.
Signed:
(see comment below about using UWA email instead of ink signatures)
Name: Click here to enter text. Date: Click here to enter a date.
UWA policy deems this document as signed if you send it attached to an email from your UWA email address. Alternatively, you can sign the signature page, scan that page and send it with the other pages and application documents.
Page 1 of 2 UWA Human Research Ethics Request to Resume Project Approval – – V1.0 (2014)