Eastern Florida State College
Human Research Protection Program
Institutional Review Board (IRB) Addendum/Modification Form
Project Information:
IRB Number of Approved Research Protocol:
Title of Approved Research Protocol:
Principal Investigator:
Email:
Date
:
Name of Principal Investigator:
Phone:
Signature:
Name of Advisor/Supervisor:
Addendum/Modification:
Description of Addendum/Modification:
Reaso
n for Modification:
Notes:
•
Complete and email this form to irb@easternflorida.edu. Attach all revised/new consent forms, description of
data collection procedures and instruments, and any other documents that have been updated or created.
• Be sure to highlight all changes made to previously submitted documents.
•
Addendum/Modification requests are subject to same standards as initial IRB reviews.
•
Submission of form does not imply approval of changes; notification will be sent to PI regarding decision of IRB.
Date Received
by IRB Chair
Date of IRB Vote
(if needed)
Addendum/Modification Form
Last updated: 2015-04-07
click to sign
signature
click to edit
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