KAMUZU UNIVERSITY OF HEALTH SCIENCES RESEARCH AND ETHICS COMMITTEE (KUREC) Request for Amendment/Modification Please complete the following: KUREC REF. Number Date of Request (KUREC will not process requests without this number.) Principal Investigator Name Contact Person (if other than PI) Phone # Email Phone # Email Title of Study 1. Description of proposed changes: (Note: Changes may not be implemented before KUREC approval) Use attachments and additional pages, as needed. 2. Reason for Amendment/Modification: 3. Changes to Consent Form: Are changes required? No form) Yes (If Yes, attach new consent Signature of Principal Investigator Date KUREC Office Use only: (1) Approval of Changes /Modifications by KUREC Approval date: Amendment Version 1.0 12 Feb 2026


