On-line submission

Dear Investigators

The research and ethics committee of Sultan Bin Abdulaziz Humanitarian City (SBAHC) wishes that applicants should make sure that their proposals include the following components to meet the requirements of the research and ethics committee of SBAHC. Also you should submit the original research proposal along with the softcopy to the chairman of Research and ethics committee of SBAHC.

1. Cover Page
2. Official Authorization
3. Research title
4. Abstract
5. Abbreviations
6. Introduction
7. Objectives
8. Significance or rationale
9. Methodology
10. References
11. Debriefing
12. Phatient Consent Form
13. Investigators CVs
14. Signed letter of understanding

Chairman

Research and Ethics Committee

For further assistance or inquiries:
Ms. Rosalie Caballero
Clinical Secretary I
Medical Affairs
+966 5620000/1876
rcaballero@sbahc.org.sa

COVER PAGE

Title of proposal:
Name of the Submitting Institution:
Department:		Faculty:
Branch:		E-mail:
Postal Address:		Telephone:
Mobile		Fax:
Requested Start Date		Requested Duration (Weeks)
Investigator’s name		Nationality
Academic Title		Highiest Degree
Institution		Date
Investigator’s name		Nationality
Academic Title		Highiest Degree
Institution		Date
Investigator’s name		Nationality
Academic Title		Highiest Degree
Institution		Date
Investigator’s name		Nationality
Academic Title		Highiest Degree
Institution		Date
Investigator’s name		Nationality
Academic Title		Highiest Degree
Institution		Date
Investigator’s name		Nationality
Academic Title		Highiest Degree
Institution		Date
Has this application been submitted to another institution? Yes No
If yes, name of institution and date of submission:
Proposal Keywords		Proposal Keywords
Proposal Keywords		Proposal Keywords
Proposal Keywords		Proposal Keywords
Are Human Subjects Used?	Yes	Are Vertebrate Animals Used?	Yes
If Yes How many Human Subjects you need?
Signature of the Principal Investigator		Date
OFFICIAL AUTHORIZATION Download the Authorization Form Download the Informed Consent Forms

Research Topic/Title

Abstract

Abbreviations

Introduction

Objectives

Significance or rationale

Methodology

References

Debriefing

Guidelines & Declaration In order to to identify the process for collecting data that would support patient care and organization management and to outline the process of participants (e.g., patients, caregivers, employees) entry into research conducted at Sultan Bin Abdulaziz Humanitarian City (the City) following the ethical principles in compliance with the rules, regulations and pertinent laws and policies and procedures of the City related to research studies, a full consideration and attention to the following guidelines is required: 1. The researcher will complete the research proposal form according to the City’s Guidelines for research application document 2. Applications from outside the City require a cover letter from their organization requesting approval for collection of data from the City addressed to the Chairman of the Research and Ethical Committee. 3. Approving the research proposal is evident only through issuing an “Approval letter” signed by the chairperson of the research & ethics committee 4. “Approval letter” will specify the following: (1) the title of the research, (2) the principle and co-researchers, (3) effective date of initiating data collection, (4) total period of data collection, (5) information going to be retrieved about the participants and or, assessment going to be conducted. 5. As an overseas researchers, you are identified by the “approval letter” & “ID R-Type” issued by security department of the City. 6. Researcher will take the responsibly of communicating their needs with the head/manager of the target department for data collection arrangements. 7. Once an appropriate subject is identified for inclusion in the study and verbally agrees to meet with the researcher, the researcher will utilise debriefing text to familiarise the participant about the research in full. 8. The researcher will inform the patient and family about the consent process in accordance to policy IIP-4.20 Informed Consent and review the contents of the Informed Consent Form and inform the subject with the following: (Refer to policy A-3.01 Patient and Family Rights and Responsibilities) A. Description of the purpose of this study in easy language and list of all research procedures in which the subject will be involved, including the duration of the subject’s involvement. B. Description and assessment of any potential risk or discomfort, and, if any, potential benefits (physical, psychological, social, legal or other) that may be reasonably expected by participating in this research C. Description of the procedures that will be used to minimize risk, to obtain informed consent and/or assent, and to maintain confidentiality and security of information. D. The subject will be assured that their refusal to participate or withdraw from participation will not compromise their access to the organization services. 9. When subject decide to participate in research, s/he will be asked - by the researcher-to complete and sign the Informed Consent Form (attached to research proposal) with the acknowledgment of the following 1) understanding the benefit and risk(s) explained by the researcher, 2) their right to withdraw from the study and 3) the authorization for accessing medical information and publishing the results of the clinical study. 10. Informed written consent for subject participation in a research protocol must be documented in the subject’s medical record (to be photocopied by the researcher and handed to a nurse staff) . 11. Changes in protocols or criteria of the study proposal after starting data collection require approval of the Research & Ethics Committee and another written informed consent. 12. After starting research, a written progress report should be submitted to the Research & Ethics Committee every six months and a final report after the completion of the study. 13. The City should be acknowledged in presentations, posters, papers, and all other publications for facilitating data collection. DECLARATION BY INVESTIGATORS The information contained herein is, to the best of my knowledge and belief, accurate. I have read the research guidelines and accept responsibility (on behave of myself and the co-investigators) for the conduct of the procedures set out in the attached application in accordance with the City’s Procedures. Signatures of the principle investigator is required before submission to City’s Research Ethics Committee Signature of the principle investigator: Please upload the following documents: 1.Official authorization. 2.Informed consent form. 3.Saudi IDs/Igama for all researchers.
Date
File Upload

The Research & Ethics Committee members- subject to circumstances- are available to collaborate with other investigators; please tick the appropriate box accordingly

I would like to have a co-investigator from the Research & Ethics Committee.
I would like to have a Principle Investigator from the Research & Ethics Committee.

The Research & Ethics Committee is privileged to invite all investigators to present their findings to SBAHC staff; please tick the appropriate box accordingly:

Oral presentation.
Poster Presentation.