Supporting Materials: Update Form

Use this form to submit new or amendedsupporting materialsafter the study has received full approval by the REB.
Prior to study approval, supporting materials are to be included with the initial submission or with a cover letter.
To be completed by Research Ethics Office / Date Received:
Research Study
REB File No. / Protocol Identifier
(if applicable)
Title of Protocol
Principal Investigator (PI)
Name
Site Investigator (SI) Not applicable (clinical trialand/or PI has a CH appointment)
Name
Mailing Address
Phone No. / Fax No.
Email Address
Contact Person for this Research Study (person to whom correspondence should be sent)
Name
Mailing Address
Phone No. / Fax No.
Email Address
Important instructions and reminders:
  • Incomplete submissions/documents will not be processed and will be returned to sender.
  • Mailing address must be detailed enough to enable successful delivery of return correspondence. Specify dept./division/program/service, institution, building, and room no. as well as any other required information.
  • Print this form as a single-sided document.
  • Submit one copy of each proposed / amended supporting material with this form.
  • Be sure to highlight all changes on amended documents. ‘Track changes’versions will not be accepted.
  • Do not use these supporting materials until this form has been signed by the REB Co-chair.

Supporting materials:
  • Supporting materials include, but are not limited to, questionnaires, surveys, measuring instruments, information for study participants, videos, DVDs, and participant appreciation items.
  • When creating these materials, incorporate Capital Health’s logo and visual identity (available on the intranet under Marketing and Communications). Avoid using language such as ‘treatment’; compensation can be mentioned, but not the specific dollar amount or item participants will receive.
  • Remember to add / update version numbers and dates. All dates should be written as yyyy/mm/dd.
  • Place the REB’s file number in the lower left-hand corner of each page (as applicable).
  • If electronic modification of the document is not possible, print the REB’s file number on a label and affix to the lower left-hand corner of the first page. The label should also include version number and date if this information is not already specified on the document.

Section A: AttachedSupportingMaterials
Item No. / Description of Item (specify title if applicable) / Version No. / Version Date
1
2
3
4
5
6
Section B: Changes from Previously Approved Versions
Item No.
(as per Section A) / Describe and justify all changes, with reference to appropriate page numbers (as applicable):
1 / N/A (new)
2 / N/A (new)
3 / N/A (new)
4 / N/A (new)
5 / N/A (new)
6 / N/A (new)
Section C: Use
Item No.
(as per Section A) / Describe how / when / why these items will be used:
1
2
3
4
5
6

Signature Page

Supporting Materials: Update Form

Research Study
REB File No. / Protocol Identifier
(if applicable)
Principal Investigator’s Signature
Signature: / Date:
(Principal Investigator) / (yyyy/mm/dd)
Research Ethics Board Use Only
The Capital Health REB approves the use of the supporting materials described in this Update Form.
Is referral to the REB Executive Committee recommended? Yes No
Signature: / Date:
(Chair/Co-Chair, REB) / (yyyy/mm/dd)
Print Name:
(Chair/Co-Chair, REB)
Processed by: / Date Processed (yyyy/mm/dd)

Page 1 of 4Supporting Materials: Update Form REB Version: 2011/02/10