Minors Research Access Form

The safety of visitors and UGA personnel is paramount. The protection of minors participating in research activities at UGA is critical. There is tremendous value to the intellectual development of minors through participation in supervised research activities in the university setting; however, there may be some risk involved. The Policy on Minors (not Acting as Students/Employees) in Research Laboratories, Clinics, and Animal Facilities aims to help ensure the safety and security of minors. The Policy designates when they will be allowed to perform research in University laboratories, greenhouses, clinic areas, or animal facilities when not acting as a University student or employee. This form set is intended to inform you about the potential risk involved in the research activity and how it is mitigated.

This form provides basic information about the PI and the participating minor, the project, the nature of hazards encountered in the laboratory and means of mitigating any potential risk, along with assurances provided by all parties involved in this research. After submitting this form, this information will be automatically routed for electronic signature approval to both the minor participating in the research and his/her parent or guardian.


Minor's Information

Phone

Upon submission of this form, an approval request will be sent automatically to this email address. Please double check to ensure that the email address is entered correctly.

Is this individual also a participant in the Young Dawgs program?*

Parent / Guardian Information

Phone

Upon submission of this form, an approval request will be sent automatically to this email address. Please double check to ensure that the email address is entered correctly.


Principal Investigator (PI) Information

Note: If you are the PI, you will receive an email requesting your approval certification and agreement to sponsor the minor list above, including adherence to UGA's policy for Programs & Activities Serving Minors and safety guidelines.

Phone

Dept. Head Information

Phone

Project Information

Provide a description of the specific activities the minor participant will engage in and any potential hazard (see below descriptions of potential hazards) they will be working with or may be exposed to.


Specific Hazard Details

Please check ALL categories of chemicals to be used. If any are selected, please provide descriptions in the subsequent text box.

Please list the specific chemicals that will be used.

Please check ALL biological materials to be used. If any are selected, please provide descriptions in the subsequent text box.

Please list the specific biological materials that will be used.

Please check ALL categories of physically dangerous equipment/materials to be encountered. If any are selected, please provide descriptions in the subsequent text box.

Please list the specific equipment/material AND the situation in which they will be used. Please also note that contact with human cells, blood and other potentially infectious material requires the completion of Blood-borne Pathogens training before beginning work. That training can be completed here: https://usg.edu/facilities/training/pathogens/

Will any of the following be used? Please select ALL that apply.

Please list other equipment to be used that is not listed above.

Describe any physical risks to which the minor may be exposed:

Describe the lab-specific safety training the minor will complete prior to beginning work: