Institutional Review Board - Application for Research Assistance

Contact Information


Please complete the following items. Documentation will be requested if needed.

Describe how your study will gain informed consent from participants. If under 18, parent consent is needed. A completed survey infers consent by the participant, as long as all details were disclosed.

Describe how you will ensure confidentiality of responses.

Describe how you will ensure data security as the data is collected, stored and analyzed.

Provide a statement of assurance that results will not be disaggregated to the level that students or Chesapeake can be identified.

Describe the implications of these results for students and how your findings will benefit Chesapeake students.

Describe how you will return the results of the study to Chesapeake (i.e. summary report).

Please send a copy of the proposed data collection instrument (i.e. survey instrument, focus group questions, etc.) to

Approval of this request does not constitute endorsement of the study. You must obtain consent from individual faculty members for access to their classes and students. You must obtain consent from the department to obtain access to faculty and staff.