Please minimize the use of technical jargon; the IRB members may not be specialists in your academic discipline. If you have already answered any of the following questions, you may refer the reader(s) to that description instead of repeating the information below.

  1. Describe the project’s
    1. goals,
    2. design,
    3. hypotheses and/or research questions,
    4. location,
    5. procedures, and
    6. how data will be obtained.
  2. Describe your participant population(s). Include (a) age, sex, and approximate number (b) inclusion/exclusion criteria, if any, (c) method of recruiting, and (d) inducement to participate.
  3. Describe how data will be analyzed and disseminated.
  4. Describe security procedures for privacy and confidentiality (attach additional pages if necessary).
  5. Identification of Risks to Participants
    1. Please describe any foreseeable risks (physical, emotional and social) to the participants. Include any methods or devices that will be used to limit participant risk. Describe any distress that might be caused by the research. If distress is a possible outcome, describe the planned procedures for debriefing the participants after the research is conducted.
    2. If you would like to request a waiver of written informed consent, please explain how the use of written consent would impede the research or needlessly jeopardize the participants’ confidentiality. Explain how you will guarantee that oral consent has been secured.  Researchers proposing to use oral consent must provide a copy of the consent document that will be read to participants. The consent document should include the statement that completion of the research exercise will confirm the participants’ consent to participate.
    3. Please describe the consent process by explaining when and how the participants’ consent will be obtained. Describe additional steps that will be taken to ensure the participants’ right to withdraw without penalty at any time and to guarantee their privacy and ensure confidentiality. Attach the consent form to this application. If participants include minors or other populations who may not be able to give consent for themselves, describe how parents/guardians will be informed of the study and give their consent. If the research is part of an in-school or institutional study, what will teachers, officials, or administration be told about the study, and how will their permission be obtained? (See sample consent form)
  6. Attach complete copies of any interview or questionnaire instruments that will be used.