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Form 15-01 — Study Report Submission

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National Health Sciences Research Committee STUDY REPORT SUBMISSION FORM 15-01 Protocol Title : Protocol number: Principal investigator phone number: e-mail address : Sponsor name Address: Phone : Study site(s): Total Number of patients/subjects : Number of subjects received the test articles: Study articles: Dosage form: Study dose(s): Duration of the study Objectives: Promoting Scientific and Ethical Conduct of Health Research in Malawi Executive Committee: Dr M. Joshua (Chairperson), Dr S. Mndolo (Vice-Chairperson) Registered with the USA Office for Human Research Protections (OHRP) as an International IRB IRB Number IRB00003905 FWA00005976 Email: research@mail.gov.mw

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Rendered from the linked Office original — page 1; retained table layout and symbols. This is a render, not an official PDF page.

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Results: (Use extra blank paper, if more space is required.) Principal investigator: Date: Promoting Scientific and Ethical Conduct of Health Research in Malawi Executive Committee: Dr M. Joshua (Chairperson), Dr S. Mndolo (Vice-Chairperson) Registered with the USA Office for Human Research Protections (OHRP) as an International IRB IRB Number IRB00003905 FWA00005976 Email: research@mail.gov.mw

Rendered from the linked Office original — page 2; retained table layout and symbols. This is a render, not an official PDF page.
Rendered from the linked Office original — page 2; retained table layout and symbols. This is a render, not an official PDF page.

Official source for this passage