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Ax:52/V7.

CHECKLIST FOR RESEARCH INVOLVING STUDENTS, EMPLOYEES OR RESIDENTS

(VULNERABLE POPULATION)
Investigator: IEC Ref:

Study Title: ……………………………………………………………………………………………

………………………………………………………………………………………………………….

Participants who are students, employees or residents require special considerations:

Does the employer or supervisor of the research No Yes


participant need to be aware of the research project?
Is there a letter of support and/ or internal services No Yes
checklist?
Have the participants been assured that their status No Yes
(education, employment, and/or promotion) will not be
affected by any decision to participate or not?
Have the risks to participants been minimized? No Yes
Have participants been assured that participation is No Yes
voluntary (no signs of coercion)?
Have participants been assured that confidentiality No Yes
will be protected or maintained?

Signature of Principal Investigator: Date


_________________

IEC Office use only


Comments:

Primary Reviewer(s) Signature & Date

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