Low or Medium Risk Research Ethics Approval
Deadline is 10 Aug 2020 - 15:00 (Harvard style reference only)
Total word limit- 2000 words (check each box for word count limit)
(To see samples, see at the bottom)
Project Title
Insert Title Here
Record of Approval
Principal Investigator
I request an ethics peer review and confirm that I have answered all relevant questions in this checklist honestly. X
I confirm that I will carry out the project in the ways described in this checklist. I will immediately suspend research and request new ethical approval if the project subsequently changes the information I have given in this checklist. X
I confirm that I, and all members of my research team (if any), have read and agreed to abide by the Code of Research Ethics issued by the relevant national learned society. X
I confirm that I, and all members of my research team (if any), have read and agreed to abide by the University’s Research Ethics, Governance and Integrity Framework. X
Name: Your name here
Date: xx/xx/20xx
Student’s Supervisor (if applicable)
I have read this checklist and confirm that it covers all the ethical issues raised by this project fully and frankly. I also confirm that these issues have been discussed with the student and will continue to be reviewed in the course of supervision.
Name: Leave Blank
Date: Leave Blank
Reviewer (if applicable)
Date of approval by anonymous reviewer: Leave Blank

Low or Medium to High Risk Research Ethics Approval Checklist
Project Information
Project Ref P12345
Full name
Faculty Health and Life Sciences
Department School of Nursing, Midwifery and Health
Supervisor Leave Blank
Module Code 7118SOH
EFAAF Number Not Applicable
Project title Title here
Date(s) xx/xx/20xx - xx/xx/20xx
Created Leave Blank
Project Summary
[Suggested word count = 100]
Names of Co-Investigators and their organisational affiliation (place of study/employer) Your name here
Is the project self-funded? Yes
Who is funding the project? Study Leave
Has the funding been confirmed? Yes
Are you required to use a Professional Code of Ethical Practice appropriate to
your discipline? YES / NO
Have you read the Code (if applicable)? YES / NO / Not Applicable

Project Details
What is the purpose of the project? Include your research question: [Suggested Word count = 100]
What are the planned or desired outcomes? Include your research objectives: [Suggested Word count = 100]
Explain your research design What is your epistemology or design philosophy, and how does this inform your choice of research methodology? What form of methodology are you using? Quantitative, Qualitative or mixed methods? [Suggested Word count = 500]
Outline the principal methods you will use Explain how you will conduct this research in detail (i.e. how you will use surveys, interviews, literature searching etc), how you will determine your sample (if empirical research), or how you would design your literature search strategy (if a systematised literature review) [Suggested Word count = 1000]
Are you proposing to use an external research instrument, validated scale or follow a published research method? YES / NO
If yes, please give details of what you are using
Will your research involve consulting individuals who support, or literature, websites or similar material which advocates, any of the following: terrorism, armed struggles, or political, religious or other forms of activism considered illegal under UK law? YES / NO
Are you dealing with Secondary Data? (e.g. sourcing info from websites, historical documents) YES / NO
Are you dealing with Primary Data involving people? (e.g. interviews, questionnaires, observations) YES / NO
Are you dealing with personal or sensitive data? YES /NO
Will the Personal or Sensitive data be shared with a third party? YES / NO
Will the Personal or Sensitive data be shared outside of the European Economic Area (-EEA-)? YES / NO
Is the project solely desk based? (e.g. involving no laboratory, workshop or offcampus work or other activities which pose significant risks to researchers or participants) YES / NO
Are there any other ethical issues or risks of harm raised by the study that have not been covered by previous questions? YES / NO
If yes, please give further details
NB: A normal (complete) CU Ethics form may also include additional requests for information, particularly for empirical studies, including:
• DBS (Disclosure & Barring Service) formerly CRB (Criminal Records Bureau)
• External Ethical Review
• Confidentiality, security and retention of research data
• Participant Information and Informed Consent
• Risk of harm, potential harm and disclosure of harm
• Payments to participants
• Capacity to give valid consent
• Recruiting Participants
• Online and Internet Research
• Languages and translations
• Laboratory/Workshops
• Research with non-human vertebrates
• Blood Sampling / Human Tissue Analysis
• Travel
this file is Sample project
This is a Supplementary Sample project