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Research Administrative Clearance Form

Section A: Investigators' Information

 

Fill in the research Team leaders' Names
Fill in the research Team leaders' Email
Fill in the research Team leaders' Phone Number
List all institutions affiliated with the research and their roles.

Co-Investigator Details 

Section B: Study Information

Give a brief description of the study design
Summarize your study objectives

Section C: Ethical Considerations

What benefits will the study bring to individuals, communities, policy, science or institutions
Describe Anticipated risks to participants and how they will be minimized
Explain how participants will be included/excluded and how fairness will be ensured
Describe how participants identities and data will be protected
Indicate how and if participants will be compensated or reimbursed
How will the community be engaged in the research design, implementation and results sharing
Outline measures to securely collect, store, access, & share research data.

Section D: Regulatory

Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Diploma Students (UGX 50,000=), Degree Students (UGX 100,000=), Masters Students (UGX 150,000=), PhD/Projects (UGX 300,000=). Call 0772999561 to get Hospital Account Number

Section E: Declarations

State whether you have any conflict of interest in this study

I hereby commit to undertake the study in accordance with ethical standards & declare that the information provided is accurate and truthful.

Write Full Name
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