Progress Report/ Completion Form
If you need continuing review of an ongoing project or are requesting an extension, please do NOT use this form. This is for study closeout only.
Today's Date
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Month
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Day
Year
Date
Lead Investigator/Faculty Advisor
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Student Investigator/Additional Investigator
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Project Title
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REC Approval Number
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Approval expiration date
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Month
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Day
Year
Date
Please indicate if you are submitting a progress OR closeout report.
Please Select
yearly progress report
study completion / closeout
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Enrollment Statistics
Please fill in the blanks below to indicate enrollment statistics for your project. If you have completed archival research and did not recruit participants, please enter "N/A"
Total number enrolled
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Total number of withdrawals
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Total number of participants that completed the study
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Reason(s) for withdrawal
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Reporting
Do you have any unanticipated or serious, adverse events regarding your project to report?
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Please Select
Yes
No
If you answered yes above, please provide details related to these events here. Please type "N/A" if this is not applicable to your project.
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Please provide a brief overview of the outcomes / progress of your project. If you are terminating your project early (i.e. without completion) please explain the reason for discontinuing this research. You may attach a separate document for this if you want.
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Upload any supporting information here. You may also use this to upload a document with your progress overview if preferred.
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Name of Person Submitting Form
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Signature
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