The University of Texas at El Paso
Human Research Oversight & Compliance Office
Notice of Intent for Collaborative IRB Project (NICP)

Exit Survey
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The Purpose of this form is to provide enough information to the collaborating IRBs to allow them to make a determination about which IRB will be the Reviewing IRB (also known as the Lead IRB) and which institutional IRB(s) agree to rely on the Reviewing IRB.

Reminder - You are not allowed to initiate research at your organization until approval from the Reviewing IRB as well as all applicable agreements have been executed and an IRB determination has been issued.
GENERAL INFORMATION
Contact Information
What is your role in the project? (Check all that apply)
Will this project be funded?
Which institution will receive or has received the award/grant?
Please provide the Study Title.
Please provide the Principal Investigator's name.
Please list all the collaborating sites participating in this project.
Please provide an e-mail address for the Principal Investigator.
Does this project include vulnerable participants (check all that apply)?
Which location(s) or where will subjects be recruited?
How will participants be recruited (please check all that apply)?
Will participants be subject to any medical procedures during the course of the project (check all that apply)?
INVESTIGATOR(S) AND RESEARCH TEAM QUALIFICATIONS
Do you and your research team members have current human subjects training?
Are you or anyone on your team qualified to perform the medical procedures mentioned above (if applicable)?
Do you or any of the research team members have any significant financial interest related to this research?
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