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):
- Blood pressure monitoring with the use of equipment.
- Blood testing/finger-prick blood sampling.
- BMI/weight measurement/calculation.
- General fitness assessment with the use of equipment.
- Provision of general or specific advice before or after results of testing.
- You need to copy the table below into an email (or a word document attached to an email), complete and forward to the Insurance Office for assessment.
- Attach any relevant information sheets, consent forms or contracts.
- You will receive a reply within 5 working days.
- Be sure to provide an answer in each field as the information feeds into a data base required by our insurer. Please do not say "refer to ethics form".
RESEARCH PROJECT INSURANCE APPLICATION:
|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:|