Radford University upholds the principles of the Belmont Report, which is included in its entirety on this page. ¼ Belmont University Institutional Review Board. The IRB is charged with reviewing all federally protected human subject studies conducted under the auspices of Belmont University. Protocol Modification Request. Application for IRB Review (Expedited or Full) Level of Review Requested: Expedited ( ) Full ( ) Title of Project: Date proposal submitted to the IRB: Proposed start date of project: (Note: Start date should be at least a month from submission date) Type of Proposal or Activity: ( ) New proposal ( ) Renewal ( ) Modification . CONSENT TO PARTICIPATE IN RESEARCH [Insert title of the study] {Insert study subtitle if applicable} If the study involves using different consent forms for different populations, identify the population group as the subtitle of the study. Belmont faculty and staff who serve as IRB committee members are appointed by the Provost and serve three year terms which can be renewed. IDENTIFICATION OF INVESTIGATORS [Suggested text]: In the event of a research related injury or if you experience an adverse reaction, please immediately contact one of the investigators listed below. Belmont University - Institutional Review Board. If the subject will be reimbursed for expenses such as parking, bus/taxi,, etc., state so FINANCIAL COSTS TO THE SUBJECT (Note: If this does not apply to your research, please omit this entry and delete the heading.) This form is to be used when requesting an annual renewal of IRB approval of a protocol that has current IRB approval. Exempt Verification Application . Investigator Progress Report. Belmont University Institutional Review Board. WITHDRAWAL OF PARTICIPATION BY THE INVESTIGATOR [Suggested text]: The investigator may withdraw you from participating in this research if circumstances arise which warrant doing so. Belmont University Institutional Review Board. Institutional Review Board Bass Hall 416 Smith College Northampton, MA 01063. When your project is completed, you should e-mail this completed Final Report Form (project completion form) to irb@mail.belmont.edu. within the research protocol: Describe the kinds of recordings that will be made. N o s t u d y i s w i t h o u t s o m e r i s k . Title of Project: Date proposal submitted to the IRB: Type of Proposal or Activity: ( ) New proposal ( ) Modification . The IRB meets regularly, usually once a month. – Ş : Belmont University Institutional Review Board CONSENT TO PARTICIPATE IN RESEARCH [Insert title of the study] {Insert study subtitle if applicable} If the study involves using different consent forms for different populations, identify the population group as the subtitle of the study. Project Title: Principal Investigator: Associate Investigator(s): Faculty Sponsor (if applicable) : Use of audio and/or video recordings. Remember that once a subject signs the consent form, you are required to give that person a copy. If consent will be obtained from a legal representative of the subject, the direct benefit to the subject must be elaborated in the consent form. Project Title: Principal Investigator: Associate Investigator(s): Faculty Sponsor: (if applicable) Use of specimens. Undergraduate Departmental Review Application . Letter of Agreement. Specimens Release Form. 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