Research Proposal Form for IRB Approval

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Basic Informaiton about the Principal Investigator

Name *
College *
Department *
Degree *
Academic Rank *
Email / البريد الإلكتروني *
Phone / الجوال *
Employee No. / ID. *
National ID. / Iqama No. *
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Basic Information about the First Co-Principal Investigator

Name *
College / Institution *
Department *
Position *
Email / البريد الإلكتروني *
Project Title *
What type of this proposal is? * *
Estimated proposal/project duration? (Write number in months) *
If your study involves another organization, please provide details. Evidence that the relevant authority has given permission should be attached or available upon request. ( pdf, doc, docx) *
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What are the sources of funding for this study and will the study result in financial payment or payment in kind to the department or College? *
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Specific Details of the Project

Please provide a summary of the project in simple prose outlining the intended value of the project, and giving the necessary scientific background. (Minimum 250 words).  *
Where will the study take place (please provide the name of the institution/department)?  *
Please outline any ethical issues that might arise from the proposed study and how they will be addressed (like confidentiality issues)  *
Please provide the sample size and its justification  *
Will the research include children or vulnerable adults such as individuals with mental health problems, learning disabilities, prisoners, elderly, or young offenders? How will you ensure that participants in these groups are competent to give consent to take part in this study? (Attach correspondence to parents, guardians, careers etc.) ( pdf, doc, docx) *
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Will payment or any other incentive, such as gift service or free services, be made to any research participant?  *
If the answer is "yes" in above question, please describe it below  *
Describe how potential participants will be identified, approached, and recruited. (Sampling Techniques)  *
Will BPC students be involved as participants in the research project? (NOTE: If yes, care must be taken to ensure that they are recruited in such a way that they do not feel any obligation to a teacher or member of staff to particate)  *
Please describe the process you will use when seeking and obtaining consent  *
Will any form of deception be used that raises ethical issues? If so, please explain?  *
Will these particiapnts participate in any activities that may be potentially stressful or harmful or harmful to connection with this research?  *
If answer is "Yes" in previous question, please describe in detail the nature of the risk or stress and what specific steps will be taken to minimize and monitor this risk or stress? But if the answer is "No", then write NILL here  *
Will group of individual interviews/questionanaires discuss any topics or issues that might be sensitive, embarrassing or upsetting? If so, please list these topics and explain how you will prevent or respond to volunteer discomfort?  *
Please describe any expected benefits to the participant  *
Does the research involve the use of drugs? (If "Yes", please name the drug/product and its intended use in the research and attach the relevant documents, such as "the proposed volunteer contracts", " Full declaration of financial or direct interest", "Copies of related certificates" 
Will any ionizing radioactive substances be used on the research participants?  *
Will X-Rays be used? *
If the answer is "Yes", please provide the details and raionale of this process. *
Will these be any invasive procedures? 
Will the study involve any physical contact? 
Any procedure(s) that may cause mental distress? 
Please state briefly any precautions being taken to protect the health and safety of the research participants  *
Please note any special or unusual circumstances related to this research, which might give rise to special concern for the welfare of research participants and describe how these special concerns will be addressed  *
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Documents submission and undertaking

Please tick ✓ the Check boxes. All Required *
Please confirm to send a copy of the appropriate supporting documentation from the following on EMAIL src@bpc.edu.sa*
YES
Questionnaire(s) / Psychological Tests*
YES
Relevant correspondence relating to involvement of collaborating department*
YES
Parental/guardian consent form for research involving participants under 18
YES
Participant/s consent Sheet
YES
Participant/s consent form/s
YES
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YES
I undertake the following.
Declaration / Undertaking *

I have read the form and submit all corrected Information

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معلومة

تم إنشاء مركز البحث العلمي بكليات بريدة في عام 1439هـ تطبيقاً للائحة الموحدة للبحث العلمي في الجامعات السعودية التي أقرها مجلس التعليم العالي في قراره رقم (2/10/1419) بجلسته العاشرة بتاريخ 6/2/1419هـ والمتوجة بموافقة خادم الحرمين الشريفين رئيس مجلس التعليم العالي بالتوجيه البرقي الكريم رقم 7/ب/4403 وتاريخ 2/4/1419هـ. , ويتولى المركز توفير بيئة بحثية مناسبة من خلال تشجيع وحث أعضاء هيئة التدريس والباحثين والطلاب على إجراء البحوث العلمية المبتكرة.