Supplemental Forms

Conflict of Interest (COI)

In order to protect subjects from financial conflicts of interest *or perceived conflicts of interest,* the IRB requires that such potential conflicts be disclosed. If the IRB determines that a conflict exists that could influence the research or jeopardize the well-being of subjects, the IRB may require additional information about the conflict or may require that the conflict be resolved before the research is approved.

If you or any member of your immediate family (spouse, children, parent, in-laws, and siblings) has a financial interest in either a public or private company whose drug, procedure, technique, device, or software is used or tested in any study, fill out this form to disclose the conflict when your research protocol is being reviewed. 

If a COI becomes apparent within the course of your study, you must immediately disclose it to the IRB.

Investigator and Faculty Advisor Assurance Forms

These forms are to be signed by you and your Faculty Advisor; they outline each of your roles and responsibilities through the research process. 

Location Community Memorial Healthcare 147 North Brent Street 7th Floor Ventura, CA 93003 Phone 805 948 5683 E-mail Hours Staffed alternating Mondays 7AM - 3PM * 24 hour access with proxy reader for CMH community
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