CENTRAL AUSTRALIAN
HUMAN RESEARCH ETHICS COMMITTEE
ANNUAL PROGRESS / FINAL REPORT 1. CAHREC REFERENCE NUMBER:
2. Title of Project:
3. Principal Investigator:
4. Status of project: (Check one)
Completed (please attach a Final Report – Q13) In progress (please attach a Progress Report – Q13) Abandoned prematurely (please attach an explanation)
Not yet commenced but appropriate to keep ethics approval current (please attach an explanation)
Will not commence and appropriate to terminate ethics approval Reason: Not funded / Investigator left / Other
5. Date the project was commenced:
6. Date the project is expected to be completed:
7. Is this an Extension on the last approved completion date: Yes / No If YES please attach an explanation
8. Compliance:
Has the conduct of the project been in accordance with the general conditions stated in the NHMRC National Statement on Ethical Conduct in Research and
with the approved protocol? Yes/No If NO, has approval for amendments to the protocol been previously sought
from the Committee? Yes /No If NO, please attach relevant documentation and an explanation on why
permission to amend the protocol was not sought from the Committee prior to these changes.
Please supply 18 copies of this report, including all documentation.
Page 1
9. Adverse Events
Has participation in the project resulted in any adverse effects on subjects? Yes / No If YES, please attach information on what steps have been taken or are
proposed to deal with these.
Please supply 18 copies of this report, including all documentation.
Have any other unforeseen events or ethical problems or issues arisen to date? Yes / No If YES, please attach details.
Please supply 18 copies of this report, including all documentation.
10. Confidentiality
Do you consider the security of the data collected during the research and
the conditions governing access to such data to be adequate? Yes / No If NO, please attach details.
Please supply 18 copies of this report, including all documentation.
11. Investigators and Research Team Members
Have there been any changes to the Investigators or Project Team Members
since your last report? Yes / No If YES , please provide details (advise the name of any individuals no longer
involved in the project and/or include name, qualifications, position and contact details for any new individuals)
12. Publications
Have any publications, either in referred journals or non-referred publications,
resulted from this research? Yes / No If YES, please cite full publication details.
13. Attachments Required
A report, in plain English, on the project’s outcome or progress to date, with all important findings/conclusions included. This should be no more than ½ - 1 page: please do not forward large reports.
As appropriate, documentation relating to any of the above questions.
--- PLEASE SIGN HERE
Principal Investigator’s Name: ...
Signature: ... Date: ...
Have your contact details changed? – IF SO, please provide new details:
Postal Address ...
...
Email ... Phone... Fax ...
- 2 -
Should you wish to discuss this report please email [email protected] When you are satisfied that your report is complete, PLEASE SUBMIT:
1 single-sided, signed original, including all attachments (original or digital signatures)
3 double-sided hard copies of the signed original, including all attachments (unless required to supply 18 copies at Q8, Q9 or Q10)
1 electronic copy of the signed original, including all attachments:
please email these through as one attachment, not as multiple files
TO: The Secretariat Support
Central Australian Human Research Ethics Committee [email protected]
By courier: Secretariat Support CAHREC
Centre for Remote Health cnr Simpson and Skinner Sts ALICE SPRINGS
NT 0870
By post: Secretariat Support CAHREC
PO Box 4066 Alice Springs NT 0871
- 3 -