Ethical Application Form
Indian Academy of Oral Biology (IAOB)
1. Registration No. (Filled by Office)
2. Project title
3. Type of Project
4. Principal Investigator Information (Name, Designation, Full Address Contact Number and Email)
5. Co-Investigator Information (Name, Designation, Full Address Contact Number and Email)
6. Co-Investigator(s) Information (Name, Designation, Full Address Contact Number and Email)
7. Duration of Project (Months)
8. Consent will be taken?
9. If Yes, Type of Consent?
10. Introduction and Background
12. Research Question
15. Sample Size
16. Do your research involves any of the following options. Please check the appropriate box
Physically invasive procedure on patients such as blood collection, exercise regimens or physical examination, and which is not part of their clinical management?
Administration of any form of drug, medicine (other than in the course of standard medical procedure) or placebo?
Physical pain, beyond mild discomfort?
Obtaining and storage of blood, body fluid or tissue samples from the participants?
The participation of minors (under 18 years), other than in the observation of normal school activity?
Participants who are in a dependent situation, such as students or residents of an institution (such as a hospital, nursing home or prison or patients highly dependent on medical care)
Participants who may be unable to give or incapable of giving informed consent?
Participation of Aboriginal or Tribal, or other people from identifiable cultural, ethnic or minority groups?
Acquisition of data about organisations or individuals through any form of database and in which those organisations or individuals are directly or indirectly identifiable?
Use of questionnaire or interviews which may be linked either directly (Example: through recording of names) or indirectly (Example: through a cross-linked code) to the individual?
Treatment modality (Manual therapy) involved, especially in cross gender scenarios
Conflicting professional limitations between participants and researchers?
Use of questionnaire, interview, or procedure irrespective of the recording of the individual’s identity, which might be reasonably expected to cause discomfort, embarrassment, or psychological or spiritual harm to the participants?
Processes that potentially exclude and/or disadvantage a person or group, such as the collection of information which may expose the person/group to discrimination or misrepresentation?
Collection or disclosure of personal information that might involve a breach of an Information / Privacy.
Payments or inducements, other than reasonable recompense, to participants for their participation?
Persons with an intellectual or mental impairment
Ionising radiation (X-rays, Microwave, LASER, Radioisotopes, UV rays)
Human genetic research
Stem Cell Research
Disclosure of the response outside the research which could place the participants at risk of criminal prosecution or civil liability or be damaging to their financial standing, employability, professional or personal relationships?
Is the present study part of any other major / multicentre / meta-analysis of large study
Any other ethical issue of the study which has not been addressed in this Checklist?
17. Aims and objectives of the study
I agree to the terms and conditions to the Institutional ethical committee IAOB that are set in accordance to the Indian Council of Medical Research (ICMR)
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service