Notification of Temporary Or Permanent Change of Principal Investigator

Notification of Temporary or Permanent Change of Principal Investigator

Instructions:

The current Principal Investigator (PI), the new PI, and the Department Head must sign this form.

Attach this completed form to the "Amendment Coversheet" in question 1.2 then "Edit the Application" as follows:

1) Do not change the PI name in the Application question in 1.1. Once approved, the REB will change the name of the PI and will issue the certificate of approval to the new PI.

2) If the current PI is going on a temporary leave and still needs to access the study in RISe, then add their name to the list of co-investigators in question 1.3

3) Ensure that any study documents (e.g. consent or assent forms) are revised to reflect the change and attach these in the Application in View 9.

Note: If this is a temporary change, when the PI returns then an amendment must be submitted to reverse this change.

Study #

/ Project Title:

Current Principal Investigator

I am the current PI for the above study and relinquish my role as principal investigator to the new PI noted below.
Effective date:
I will remain as a co-investigator on the study.
I will be removed from the study.
Name of PI:______Signature:______

New Principal Investigator

I accept the role as Principal Investigator for the above study.
I agree to abide by the Tri-Council Policy for Ethical Conduct for Research Involving Human Subjects.
Conflict of Interest:
I have reviewed the RISe application question on page 2 regarding Conflict of Interest and
I do not have any conflicts.
I have a conflict of interest. Brief Description:
Name of PI:______Signature:______

Department Head:

(If absent, the Department Head's alternate "Department Reviewer" may sign)

Declaration: I confirm that the new Principal Investigator noted above has the qualifications, experience, and facilities to carry out this research.
Signature:______
Print Name:

Version Date: June 14, 2007 Page 1 of 1