Continuing Review and Study Closure Notification Form GPH-IRB

Ghana Police Hospital (GPH), Institutional Review Board (IRB)

Continuing Review & Study Closure Notification Form

This form is to be used by investigators to request continuing ethical approval for an ongoing study or to formally notify the Ghana Police Hospital Institutional Review Board (IRB) of study completion or early termination.

GHANA POLICE HOSPITAL (GPH)

INSTITUTIONAL REVIEW BOARD (IRB)

CONTINUING REVIEW AND STUDY CLOSURE NOTIFICATION FORM

SUBMITTER INFORMATION

Name of Person Submitting Form
Submitter Email

SECTION 1: STUDY IDENTIFICATION

IRB Reference Number
Title of Study
Principal Investigator
Institution / Affiliation
Original Date of Ethical Approval
Current Approval Expiry Date

SECTION 2: TYPE OF SUBMISSION

Select Submission Type

[radio* submission-type use_label_element default:1 "Continuing-Review-Renewal" "Study-Closure" "Early-Termination"]

SECTION 3: PROGRESS REPORT (FOR CONTINUING REVIEW)

3.1 Summary of Study Progress to Date
3.2 Number of Participants Approved vs Enrolled
3.3 Summary of Any Deviations from Approved Protocol
3.4 Summary of Adverse Events or Unanticipated Problems
3.5 Assessment of Ongoing Risk-Benefit Balance

SECTION 5: REQUEST FOR CONTINUED APPROVAL

Requested Continuation Period

SECTION 4: AMENDMENTS AND CHANGES

Have there been any amendments?	No AmendmentsAmendments Submitted and Approved
Attach Amendment Details (if applicable)

SECTION 6: STUDY CLOSURE / TERMINATION REPORT

6.1 Date of Study Completion or Termination
6.2 Reason for Early Termination (If Applicable)
6.3 Confirmation that no further participant contact or data collection will occur	[radio* participant-contact-confirmation use_label_element "Yes" "No"]
6.4 Summary of Final Outcomes

SECTION 7: DATA MANAGEMENT AND FINAL DISPOSITION

Describe plans for final data storage, confidentiality, and dissemination of results

SECTION 8: DECLARATION AND SIGNATURE

I certify that the information provided in this report is accurate and complete. I confirm that the study has been conducted in accordance with the approved protocol and ethical requirements and that the IRB has been notified of study completion or termination where applicable.

Name of Principal Investigator
Signature
Date

No: 1 Hospital

Send us a Message

Opening hours

Know Us Better

Our Departments

Satellite Clinics