:: Submission Forms: Initial Protocol

 

Application Forms for Human Ethics Reviews :


First submission : original and 3 copies documents.

 

Resubmission : original and 1 copy document.

 

Click to Download

 

1. Cover letter form. (EC-1)
  English
Staff

 

EC1.1a

(1 original + 3 copies)

 

Resubmit

(1 original + 1 copie)
Student

 

EC1.2a

(1 original + 3 copies)

 

Resubmit

(1 original + 1 copie)

 

2. Project proposal. (EC-2)

 

 English

 

Staff

 

 

EC-2.1
(1 original + 3 copies)

 

 

Student

 

 

EC-2.2

(1 original + 3 copies)

 

 

3. Information sheet. (EC-3)

 

 English

 

 

EC-3

(1 original + 3 copies)

 

 

4. Informed consent form. (EC-4)
  English
Informed consent

 

EC-4

(1 original + 3 copies)

 

Assent form (for children aged 7-12 years old)

 

 

Assent form

(1 original + 3 copies)

 

 

5. Questionnaire/Interviewing Form/Program or Activity Plan (1 original + 3 copies)

 

6. Curriculum vitae and Published researches. (1 original + 3 copies)

    6.1 Principal investigator : Curriculum vitae with publihed researches. (within previous 5 years)

    6.2 Research Student : Student's curriculum vitae with published researches and Major Advisor's curriculum vitae with published researches and advilor's signature. (within previous 5 years)

 

7. The Thesis/Thematic paper proposal examination. (4 copies)

    7.1 In case of the result is "Passed". Please copies GR.33 form and/or GR.1 form

    7.2 In case of the result is "Passed with Conditions" or "Not Passed". Please copies GR.37 form and/or GR.1 form

    7.3 The Faculty of Graduate Studies' Administrative Order for the thesis topic.

 


8. A copy of all investigator's certificates that recived from Ethics in Human Research trainging. (Not over 2 years from the training day) (4 copies)

 

 

9. A copy of the receipt of the ethics submission fee.

 

 

10. The documents will be written on one compact dist (CD)

     10.1 Item 1-9 in a folder.

     10.2 The Thesis/Thematic paper proposal that passed the examination in another folder. (Research Proposal Chapter 1-3)

 

 

11. Case study research : Retrospective study/Medical record review/Case report/Secondary data, Please copy cover letter from Head of authorized person of the designated institute.

 

 

12. Case study research : Stored specimen, Please copy cover letter from Head of authorized person of the designated institute.

 
  English

 

13. Checklist for Ethical Review Committee for Human Research

 

 Checklist_Eng

 

 

Suggestion for M.P.H Program and Dr.P.H. Program students.

- EC-3, EC-4 and Questionnaires should be written both in English and your subjects' mother language.

 

-The purpose of EC-3 (Information Sheet) is for communication with the subjects. It should be written in briefly and easily understand for the subjects and use "you" instead of "respondent". It should not longer than 2 pages.

 

- Please edit your submitted date at footnote in EC-1, EC-2, EC-3, EC-4 and Questionnaire/Interviewing Form/Program or Activity Plan.
 
 
 
------------------------------------------------------------------------------------------------