IRB Annual Renewal Form

You must have an IRB Approval before you can continue your research project after its annual expiration date.

IMPORTANT: Please complete this form and request a copy be sent to your email for your records. Then forward the email to the IRB Admin at irb@nmt.edu

Previous IRB Information

All contact information provided must match the information on original IRB Approval Form.

Primary Investigator Name:

Department:

Primary Contact #:

Phone

Today's Date

mm/dd/yyyy

Primary NMT Email:

Original Project IRB Database Number:

Numbers only

Title of Project To Be Renewed:

Funding Source/Agency:

Original Period of Research Project:

Project IRB Approval Date:

mm/dd/yyyy

Project IRB Expiration Date:

mm/dd/yyyy

Renewal Details:

Changes Made?

Have you (or your research team) made any changes to the research project since it was approved by the IRB? The IRB also asks that you provide written explanation for any changes. It should be attached with this form but can be sent afterwards directly to irb@nmt.edu.

Yes

Annual Progress Report Provided?

A brief project progress report is required before the renewal will be reviewed. It should be attached with this form but can be sent afterwards directly to irb@nmt.edu.

Yes

No - I understand my renewal will not be reviewed until it is submitted.

Principal Investigator/Researcher Assurance:

As principal investigator/researcher, I hereby assure that the information I have provided on this form is correct and accurate, to the best of my knowledge.

Faculty Advisor Assurance:

Is a faculty advisor assurance required?

Yes

File Upload

Multi-year projects are initially approved by the IRB for a 12-month period. Please attach a brief report describing your progress to the IRB to this form. Attach any other necessary documents here as well.

~Thank you

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