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IRB Research Application
Blinn College Institutional Review Board
Section I: Project Information
Application Type
Project Title
Principal Investigator
Email
Phone
Blinn Connection
Institution Conducting Study
Faculty Sponsor (if applicable)
Project Type
Faculty Research Student Research Class Project Grant-funded Thesis/Dissertation Other
Proposed Start Date
Duration (months)
Research Locations
Section II: Investigators
Co-Investigators
Student Investigators
Other Contacts
Section III: Compliance Checklist
- Participants under 18
- Collects identifiable data
- Shares identifiable data
- Offers incentives
- Participation is voluntary
- Participants recorded (audio/video)
- Participants informed of risks/benefits
- Privacy/confidentiality protected
- Participants debriefed
- Written informed consent obtained
- Data sources identified
If incentives are offered, describe:
Section IV: Research Details
Research Objectives
Participant Description & Recruitment
Data Collection Methods & Confidentiality
Risks and Mitigation
Costs to Participants
Compensation
Benefits of Research
Results Dissemination
Section V: Attachments
- Informed consent form
- Surveys / questionnaires
- Risk disclosure forms
- Financial conflict form
- Letters of approval
- External IRB approvals
- Recruitment materials
- Human subjects training
Section VI: IRB Use Only
IRB File Number
Reviewer
Review Process
Exempt Expedited Full Review
Decision
Approved Not Approved Conditionally Approved
Comments
IRB Chair / Representative
Date