Eastern Florida State College
Human Research Protection Program
Institutional Review Board (IRB) Continuing Review/Termination Form
Project Information:
IRB Number of Approved Research Protocol:
Title of Approved Research Protocol:
Principal Investigator:
Email:
Dat
e:
Name of Principal Investigator:
Phone:
Signature:
Name of Advisor/Supervisor:
Participant information:
Number of participants involved to date: Number of participants remaining:
Continuing Review or Termination Request:
☐ Please terminate, research is complete.
☐ Research is not complete and I am requesting an extension to this date:
If you are requesting an extension, please check boxes below to indicate if any of the following apply:
☐ Human participants will not be involved after current IRB approval expires.
☐ Human participants may be involved during any approved extension period.
☐ No changes will be made to previously approved protocol or methodology.
☐ Changes to the protocol or methodology are being requested. (Include IRB Addendum/Modification Request)
Notes:
• Complete and email this form to irb@easternflorida.edu.
• If there are any changes to your research, include IRB Addendum/Modification request and updated documents
along with you request to extend the approval period.
• Submission of this form does not imply approval; notification will be sent to the PI regarding decision of IRB.
Date Received
by IRB Chair
Date of IRB Vote
(if needed)
Name of Form
Last updated: 2015-04-09
IRB Determination
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signature
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