Beijing Jishuitan Hospital
Institutional Review Board Approval Form (IRB)
This approval form must be included in all rearch papers and must be signed by the thesis investigator.
Project Information:
Principal Investigator:
Department: Department of , Beijing Jishuitan Hospital
Project Title:
Description of Propod Project:
PI Certification:
I certify that the information provided above is accurate. I certify that I have received the appropriate training in the proper treatment of human participants in rearch. And I certify that all procedures desc
ribed in this application are complete and accurate. All activities associated with this rearch project will be performed in accordance with Jishuitan Hospital Institutional Guidelines and Clinical Regulations. I agree to immediately report all unanticipated adver affects of the study on subjects to the Chairperson of the Beijing Jishuitan Hospital Institutional Review Board.
Signature of Principal Investigator:Date:
Chairperson, Beijing Jishuitan Hospital Institutional Review Board(print): Youqing Xin
Signature:Date:
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