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Form C: Investigator's Assurance

1.I certify that the information provided in this initial review application is complete and correct.(Required.)
2.I understand that as Principal Investigator, I have ultimate responsibility for the protection of the rights and welfare of human subjects and the ethical conduct of this research protocol.(Required.)
3.I agree to comply with all Tennessee Board of Regents (TBR) and Jackson State Community College (JSCC) policies and procedures, as well as with applicable federal, state, and local laws regarding the protection of human subjects in research, including, but not limited to the following:
  • The project will be performed by qualified personnel according to the research protocol;
  • I will maintain a copy of all questionnaires, survey instruments, interview questions, data collection instruments, and information sheets for human subjects;
  • I will promptly request approval by the JSCC IRB if any changes are made to the research protocol;
  • I will report any adverse events that occur during the course of conducting the research to the JSCC IRB within five (5) business days of the date of occurrence.
(Required.)
4.Principal Investigator's Electronic Signature- by typing your name in this box you are indicating your agreement of this document.(Required.)
5.Date:(Required.)
Date / Time