SOP 4.1-012.2015-04
Medical and Health Research Ethics Committee (MHREC)
Faculty of Medicine Universitas Gadjah Mada – Dr. Sardjito General Hospital
Effective date: 01 August 2015 Page 1 of 1 4.1. Review of Resubmitted Protocols
ANNEX 1 AF 4.1.01-012.2015-04 MEMORANDUM ADDRESSING CORRECTIONS
Protocol No.: 2nd Review 3rd Review 4th Review Protocol Title:
Principal Investigator: Tel.:
Recommended revisions: Revisions/ Modifications according to the recommendation (add extra pages if necessary):
SIGNATURES:
Date:……… Principle Investigator
TYPE OF REVIEW: ASSIGNED REVIEWERS:
Exempted from review Expedited Review Full Board Review
1.
2. 3. Reviewer for informed consent documents:
COMPLETION: