аЯрЁБс>ўџ 8:ўџџџ7џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС#` љПl bjbj\.\. 4(>D>D‚ џџџџџџЄфффффффјр р р р $ јh , ^Š Š Š Š e DЉ ,е ЗЙЙЙЙЙЙ$rhкpнEфэ e e э э нффŠ Š л"Ѕ Ѕ Ѕ э фŠ фŠ ЗЅ э ЗЅ Ѕ г ффŠ `сЁЂпNЧр ї ^ы Sd80hѓ ,JU FJJф4Ѕ э э э нн› э э э hэ э э э јјјфмјјјмјјјффффффџџџџ Brandeis University Committee for Protection of Human Subjects Faculty Sponsor's Assurance Student initiated research involving human subjects, whether dissertation, thesis, or other research projects, must be supervised by a Brandeis University faculty member to insure the compliance with procedures and regulations relating to the protection of human subjects. The signature of the faculty sponsor is required on all research where the student is identified as the principal investigator. The faculty sponsor's signature verifies that the research has been reviewed by the department and is in compliance with federal and Brandeis University policies. Name of Investigator:  FORMTEXT       Department:  FORMTEXT       Project Title:  FORMTEXT       The faculty sponsor is responsible to: meet with the investigator to monitor study progress. be available to the investigator to supervise and to address problems should they arise. oversee the prompt reporting of any significant or untoward adverse effects within 5 days of occurrence. arrange for an alternate faculty sponsor to assume these duties when unavailable (vacation or sabbatical). monitor the research activity to insure that the protocol approved by Brandeis CPHS is followed. The faculty sponsor has reviewed the protocol for the following: 1- Research design is sound and appropriate to the discipline. 2- Subject selection is fair and subjects are informed as to how they were selected. 3- Recruitment procedures to help ensure voluntary inclusion. 4- Informed consent language is appropriate to subjects. 5- Privacy and confidentiality are protected. 6- Potential benefits are described. 7- Potential risks (psychological, social, physical, economic, legal) are identified and managed. 8- Benefits outweigh the risks. 9- Informed consent document is attached (parental permission and assent when applicable). 10- Participating agencies/institutions’ letters of approval are attached. 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