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Request to Undertake Research Involving
Human Pa
rticipants at On- or Off-Campus Research Sites
Name of Principal Investigator [first last]:
Department: Faculty:
Email address: Phone:
Has ethics approval been received?
Yes / No
Is the research site located at a U of M building?
Yes / No
Will this research have direct contact with Indigenous communities? Yes / No (if the answer is “yes”, please
include a letter from the community confirming/affirming support of the continuation of research.
Will this research involve international travel (i.e., travel outside Canada) Yes / No
If the answer is “yes” please describe who is traveling, where they are traveling to/from, and for how long.
Off-campus research site:
Name(s) of all graduate student(s), postdoc(s), research associate(s), and research technician(s) involved:
Name [first last] Status
Name [first last] Status
Name [first last] Status
Name [first last] Status
Name [first last] Status
Number of human participants involved:
Please complete if research site is located at a U of M building only:
Building Room Number
(Please indicate the total number of research personnel and human participants you will have in this room for each day and
time slot)
Building Room Number
(Please indicate the total number of research personnel and human participants you will have in this room for each day and
time slot)
