Appication for Changes
Ana G. Méndez University System
Vice Presidency for Planning and Academic Affairs
Associate Vice Presidency for Sponsored Programs
Office of Regulatory Compliance
Human research protecion board
APPLICATION FOR CHANGES (AMENDMENTS) IN RESEARCH
Download this form and after completing you must upload in the IRBNet System (Applications without all requested information will not be accepted for IRB review)
(Instructions are available at http://compliance.suagm.edu)
Proposal Title:Hispanic Women's Experiences of Living with Endometriosis |
Name of Principal Investigator | Last Name First Name Cruz Corey | Title |
Email: cruz.corey@hotmail.com | Mobile Phone: 919-744-7392 | Mailing Address: City State Zip Code 5900 Avenida Isla Verde PMB 176 Suite 2 Carolina PR 00979 | Institution/Campus: Universidad del Turabo | Telephone: | Student: Yes No | School/Department: Family Nurse Practitioner | Name of Mentor/Co-Investigator: Maria Rosa | Telephone: 787-743-7979 | Funding: | | Contact Person: Mobile Phone: | Initial Approval Date: 12/ 11/ 2012 Expiration Date: 12/ 11/ 2013/ (mo-day-yr) (mo-day-yr) | Date of most recent continuing (renewal) Approval: 12/ 11/ 2012/ (mo-day-yr) |
If more space is required copy this information and attach with this form
Section A – Protocol Summary 1. * Provide a summary of the changes in the research protocol. Include population, methodology, procedures applied to subjects, and potential for subject risk. The only changes being requested are to conduct individual interviews in person or via telephone with a total of approximately 10 participants. Dr. Rosa will take notes on the answer to four open- ended questions. The sheets where Dr. Rosa
Vice Presidency for Planning and Academic Affairs
Associate Vice Presidency for Sponsored Programs
Office of Regulatory Compliance
Human research protecion board
APPLICATION FOR CHANGES (AMENDMENTS) IN RESEARCH
Download this form and after completing you must upload in the IRBNet System (Applications without all requested information will not be accepted for IRB review)
(Instructions are available at http://compliance.suagm.edu)
Proposal Title:Hispanic Women's Experiences of Living with Endometriosis |
Name of Principal Investigator | Last Name First Name Cruz Corey | Title |
Email: cruz.corey@hotmail.com | Mobile Phone: 919-744-7392 | Mailing Address: City State Zip Code 5900 Avenida Isla Verde PMB 176 Suite 2 Carolina PR 00979 | Institution/Campus: Universidad del Turabo | Telephone: | Student: Yes No | School/Department: Family Nurse Practitioner | Name of Mentor/Co-Investigator: Maria Rosa | Telephone: 787-743-7979 | Funding: | | Contact Person: Mobile Phone: | Initial Approval Date: 12/ 11/ 2012 Expiration Date: 12/ 11/ 2013/ (mo-day-yr) (mo-day-yr) | Date of most recent continuing (renewal) Approval: 12/ 11/ 2012/ (mo-day-yr) |
If more space is required copy this information and attach with this form
Section A – Protocol Summary 1. * Provide a summary of the changes in the research protocol. Include population, methodology, procedures applied to subjects, and potential for subject risk. The only changes being requested are to conduct individual interviews in person or via telephone with a total of approximately 10 participants. Dr. Rosa will take notes on the answer to four open- ended questions. The sheets where Dr. Rosa