UPOU IREC FORMS

Please download and accomplish the necessary forms:

  1. UPOU IREC Form 1 (B) Curriculum Vitae Form ↓(Word document)
  2. UPOU IREC Form 1 (C) Confidentiality Agreement (For Members, Observers or Guests of the National Ethics Committee)
  3. UPOU IREC Form 1 (D) Disclosure of Conflict of Interest Agreement (For Members and Consultants of the REC) ↓(Word document)
  4. UPOU IREC Form 1 (E) Appointment of Member Template
  5. UPOU IREC Form 1 (G) Service Agreement form
  6. UPOU IREC Form 3 (A) Recommendation form from Primary Reviewer/Chair/VC/M Sec
  7. UPOU IREC Form 6 (A) Application for Ethics Review of a New Protocol ↓(Word document)
  8. UPOU IREC Form 6 (B) Endorsement Form From Unit Head
  9. UPOU IREC Form 6 (C) Review Checklist
  10. UPOU IREC Form 6 (D) Study Protocol Assessment Form ↓(Word document)
  11. UPOU IREC Form 6 (E1) Health-Related Assessment Form ↓(Word document)
  12. UPOU IREC Form 6 (E2) Non-Health-Related Assessment Form ↓(Word document)
  13. UPOU IREC Form 6 (F) Informed Consent Form Checklist
  14. UPOU IREC Form 6 (G) Inform Consent Form Template (English)
  15. UPOU IREC Form 6 (H) Assent Form Template (English)
  16. UPOU IREC Form 7 (A) Resubmission form
  17. UPOU IREC Form 8 (A) Progress Report Form ↓(Word document)
  18. UPOU IREC Form 8 (B) Application for Ethics Review of Progress Report ↓(Word document)
  19. UPOU IREC Form 9 (A) Application for Review of Amendments
  20. UPOU IREC Form 10 (A) Protocol Deviation or Violation Report Form  ↓(Word document)
  21. UPOU IREC Form 11A (A) RNE Report Form ↓(Word document)
  22. UPOU IREC Form 11B (A) SAE/SUSAR Report
  23. UPOU IREC Form 12 (A) Application for Continuing Review  ↓(Word document)
  24. UPOU IREC Form 13 (A) Final Report Form ↓(Word document)
  25. UPOU IREC Form 14 (A) Early Termination Report Form ↓(Word document)
  26. UPOU IREC Form 16 (A) Site Visit Report Form
  27. UPOU IREC Form 25 (A) Request for Access Form

(Photo from UPOU Library)