ࡱ> ;=: `bjbjޥ *$ǴǴY Fhh&&&&B&VEN4*,,,,,,$ytP9#"EP9ccc@8*c*ccSh\7#0#@0cPPch : Institutional Review Board (IRB) Application for Amendment to a Previously Approved Protocol For Investigations Involving Human Participants ý It is the principal investigators responsibility to obtain IRB approval PRIOR to revising or altering the approved research protocol or Informed Consent documents IN ANY WAY. If the principal investigator is a student, it is the faculty sponsors responsibility to ensure that IRB written approval is obtained PRIOR to revising or altering the approved research protocol or Informed Consent documents. You must submit the signed form as a pdf document and the appropriate materials that support that request as Word documents to  HYPERLINK "mailto:msu.irb@murraystate.edu" msu.irb@murraystate.edu. Principal Investigators Name:   FORMTEXT       Faculty Sponsor s Name:  FORMTEXT       IRB Protocol Number:  FORMTEXT       Project Title:  FORMTEXT       Description of the change being requested to an approved protocol or informed consent document:  FORMTEXT       Reason for the change:  FORMTEXT       Please attach a copy of the current approved consent form. If you are requesting permission to alter this form, please attach a copy of the revised form that you wish to use with the requested changes highlighted on it. You may not implement any changes to the approved protocol or informed consent documents without prior written approval of the IRB. You must submit this signed form and the appropriate supporting documents via email to  HYPERLINK "mailto:msu.irb@murraystate.edu" msu.irb@murraystate.edu. Assurance Statement:"K U : L m          & ( , ǻίί瑃n\#jhtFB*UmHnHphu)jho;B*UmHnHphuho;B*mHnHphu#jho;B*UmHnHphuhK%htF0J5CJjhtF5CJUhxhx56CJ hx5CJ htF5CJho;5>*CJho;56CJho; ho;5CJjho;UmHnHu$"^   , " $ hj78^^ & F$a$, ^ ` t v   @BVXZdf45678L\ywsho;UhK%htF0J5CJjhtF5CJU htF5CJ ho;5CJjho;CJUmHnHujDho;CJUjho;CJUj\ho;CJUjho;CJUjtho;CJUjho;CJU ho;CJ- I certify that to the best of my knowledge, the changes that I am requesting will not alter the risk/benefit ratio as presented in the originally approved protocol. If the changes that I am requesting will alter this ratio, I understand that I MUST resubmit the full protocol with the request for alteration or revision to the IRB for a complete review. _________________________________________________________________________ Principal Investigator Date Approval by faculty sponsor (required for all students): I have read and do confirm the accuracy of this application, and I accept responsibility for the conduct of this activity. _________________________________________________________________________ Faculty Sponsor Date MSU USE ONLY IRB Log No.: ______________ MSU Proposal No: _________  $Z\^`^ & F \^` ho;5CJhm<(/ =!"#$% tDText1tDText2tDText3tDText4tDText5tDText6^ 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH 8`8 Normal_HmH sH tH B@B  Heading 1$$@&a$5CJ>@>  Heading 2$$@&a$CJ8@8  Heading 3$@&CJDA D Default Paragraph FontViV 0 Table Normal :V 44 la (k ( 0No List 6U`6 tF0 Hyperlink >*B*phPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] E EH $, \` ` %17S_e}#)DPV@X XFFFFFFX8@(  V   #" ? B S  ? tText1Text2Text3Text4Text5Text6&T~E 8f*W DWYX Y :27DW[X   hh^h`o(. 3N9o;m<tFxY [ @27224$$p @ @UnknownG*Ax Times New Roman5Symbol3. *Cx ArialA$BCambria Math"1hzData 1TableWordDocument*$SummaryInformation(*DocumentSummaryInformation82CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q