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Research Projects

All research projects involving human subjects must be assessed against our insurance to ensure that appropriate cover is in place for the research activity.

Research activity requiring insurance assessment includes (but is not limited to):


Instructions
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RESEARCH PROJECT INSURANCE APPLICATION:

  Write your
Answers Here
                       
For Office Use Only
School and Discipline conducting Research:    
Title of Research Project:    
Contact person name and number:    
Project commencement date:    
Project completion date    
Purpose of project (summary):    
Participants/Volunteers recruited from/selection process (members of general public/students/patients in hospital?):    
Total number of participants/volunteers:    
In what countries will you be conducting your research?    
Description of research activity (describe the treatment/testing and indicate whether it is considered invasive or non invasive):    
Does the research project involve the administration of drugs/minerals/vitamins, etc? If yes - is the drug/mineral/vitamin TGA approved?    
Is the research project sponsored by a third party? If yes, please advise by whom and attach a copy of the relevant contract or agreement.    
Is this research required to be notified under the "Clinical Trial Notification" or "Clinical Trial Exemption" Schemes?    
Who will be conducting the research or administering treatment? (Students/staff/volunteers/hospital staff/medical practitioners?)     
Potential risk to volunteer subjects involved (describe any known risks and whether they are considered short/long term and whether there is any follow up):    
Potential risk and/or exposure to staff involved:    
Further information and disclosures concerning insurance coverage:    
Is there an agreement with any Third Party? Eg. Hospital, aged care facility, government body etc. If yes, please attach a copy of the agreement:    
Are consent forms to be completed by patients / participants:    
Have you attached relevant information sheets, consent forms and/or contracts to this application:    

 

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