ANNUAL RENEWAL REQUEST FORM
Form 3- Faculty/Student/Staff
Research ethics approval is valid for 1 year, followed by automatic suspension. If approval is not renewed on time, research activity
must cease immediately and will have implications for administration of funds and compliance with the REB and University Integrity
policy. No option exists for retroactive approval.
INSTRUCTIONS: Send request to email@example.com (only)
1) 30 days prior to the expiry date of the approval, please send Form 3 to firstname.lastname@example.org (only);
2) Requests involving student protocols must be submitted by the Faculty Supervisor;
3) Original signature is not required for electronic submissions;
4) All information requested is material to the ethics review. It is required that all fields be completed;
5) Incomplete submissions will not be processed and will be returned to sender.
1. TITLE OF RESEARCH PROJECT
c) Original Approval Date:
e) Have there been any unreported changes to the study protocol, consent process or supporting
documents since the most recent (original, modification or annual renewal) approval?
If yes, submit a MODIFICATION REQUEST FORM Form 2 along this request. Revised procedures may not be used until approval is confirmed.
Grant title if different from Question 2:
* All fields relating to funding must be filled out so the REB can grant the necessary permission to release the research funds upon approval.
Any changes to funding must be reported to the REB.