ÐÏࡱá>þÿ ')þÿÿÿ&ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Áq ¿L bjbjt+t+ *AA7ÿÿÿÿÿÿ]2222222FFFF8~ ŠF­ ü²²²²²���r t t t t t t $© ô� j˜ 2�����˜ 22²²Û²   �2²2²r FF2222�r  %V& @22r ²¦ €¥Zkg•ÅFF£jf Protocol Completion/Termination Report Institutional Review Board (IRB) À¶Ý®ÊÓÆµ Principal Investigator: IRB Protocol #: Email Address: Phone Number: À¶Ý®ÊÓÆµ Extension: Project Title: Protocol Results: 1. Provide a brief description of the results obtained by this study (use additional pages as needed): 2. Have any articles been published using the results of this study? ( Yes ( No 3. Number of articles/manuscripts submitted or in development: 4. Total number of subjects enrolled in study: Total number of subjects completing study: 5. Did any adverse events (AE) occur? ( Yes ( No If yes, how many? ______________ Were all adverse events (AE’s) reported? ( Yes ( No 6. Please check any/all reasons applicable for protocol completion/termination request (check at least one): ( PI completed goals of study ( Protocol did not receive funding ( PI or co-PI no longer resides at institution ( Student PI has graduated ( Data analysis continuing; no further contact with study participants ( Investigator lost interest in pursuing study ( Protocol closed due to adverse event ( Other: PI Certification: I certify, as of the date below, human subjects are no longer being studied, contacted or enrolled in the protocol listed above. Therefore, this protocol should be officially designated as completed/terminated by the À¶Ý®ÊÓÆµ IRB. ____________________________ _______________ Signature of Principal Investigator Date ___________________________________ ___________________ __________________ Signature of Supervising Faculty Member Department Date ________________________________________________________________________________________________________________________________ FOR À¶Ý®ÊÓÆµ IRB USE ONLY: Date Received: ______________ Revised 6/30/2005 ab+,-?@¨®õöýþFG§¨ÏÐÖ׃„‹Œ�‘ÿ,-VWŒ�®¯üý2 3 ` a j k l ~  b c ” Ñ Ò } ~  ÿ    6 7 I L ýúýú÷ýúô÷ñ÷ë÷ë÷ô÷ô÷ô÷ë÷ë÷ë÷ë÷è÷è÷ë÷ë÷ë÷ë÷ë÷ë÷ë÷ë÷ôýúôèý÷è÷ôèô÷÷ô÷ôCJ jððCJCJCJCJCJCJG'Habìû +,-?@¨©ª«¬­ùùóíÚÚÚÚÓÚÀÓ­­­­­­­­$„0ý„0ý$d%d&d'd$„0ý„0ý$d%d&d'd$„0ý„0ý$„0ý„0ý$d%d&d'd„0ý„0ý„0ý„0ý„0ý„0ý'Habìû +,-?@¨©ª«¬­®FGw§¨�‘ÿ%O…§õ+ Y j k l ~  b c “ Ñ Ò & } ~   7 I J K L ýýûùù÷÷÷=­®FGw§¨�‘ÿ%O…§õ+ Y j k l ~ ììììììììììììììììììììììèÕ$„0ý„0ý$d%d&d'd„0ý$„0ý„0ý$d%d&d'd~  b c “ Ñ Ò & } ~   7 I J K L ìêêØìììììÔÎÈÁ¶´´Á „|ü„0ý ÆÀ!D%$„Öü„0ý„0ý„0ý„|ü„Öü„|ü„0ý„0ý$d%d&d'd$„0ý„0ý$d%d&d'd(&P°Ð/ °à=!°"°#�€$�€%°°°°@ [$@ñÿ$NormalmH @@ Heading 1$$„Öü„8„øø@&CJTT Heading 2+$$„0ý„0ý$d%d&d'd@&CJ<A@òÿ¡<Default Paragraph Font*>@ò*Title$5�CJ0J@0Subtitle$5�CJPT@P Block Text%$„0ý„0ý$d%d&d'dCJ,",Header  ÆàÀ!, @2,Footer  ÆàÀ!LÿÿÿÿL ­~ L L ð8ð@ñÿÿÿ€€€÷ð’ðð0ð( ð ððB ðS ð¿Ëÿ ?ð7JMxÔþ×Û�þ _«ÏG_7JMÿÿCSU3C:\TEMP\AutoRecovery save of AdverseEventReport.asdCSU3C:\TEMP\AutoRecovery save of AdverseEventReport.asdCSU3C:\TEMP\AutoRecovery save of AdverseEventReport.asdCSU,C:\WINDOWS\Desktop\IRBAdverseEventReport.docCSU6C:\TEMP\AutoRecovery save of IRBAdverseEventReport.asdCSU*C:\WINDOWS\Desktop\IRBCompletionReport.docCSU4C:\TEMP\AutoRecovery save of IRBCompletionReport.asdCSU*C:\WINDOWS\Desktop\IRBCompletionReport.docCSU*C:\WINDOWS\Desktop\IRBCompletionReport.docCSU*C:\WINDOWS\Desktop\IRBCompletionReport.docRN% ôm²âÿÿÿÿÿÿÿÿÿÝzϬv¾xÿÿÿÿÿÿÿÿÿ>ÍPêf¨ÿÿÿÿÿÿÿÿÿ „-„˜þÆ-OJQJo(ð𠄘þ„˜þƘþOJQJo(·ð„˜þ„˜þƘþo(.ÝzÏ>ÍRN% ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ@€,,DÞ',,,,L@@G�Times New Roman5�€Symbol3&� ArialE�€Monotype Sorts"ñˆÐh…í–fáô—Æ…í–f 0Æ!¥À´´€20dQÿÿInitial Review ApplicationCSUCSUþÿ à…ŸòùOh«‘+'³Ù0Œ˜ ÄÐÜèô   < H T `lt|„äInitial Review ApplicationnitÀ¶Ý®ÊÓÆµSUSU Normal.dotiÀ¶Ý®ÊÓÆµ5UMicrosoft Word 8.0i@vÝA@›€ }Å@›€ }Å@Æwgg•Å0Æþÿ ÕÍÕœ.“—+,ù®DÕÍÕœ.“—+,ù®` hp”œ¤¬ ´¼ÄÌ Ô ûäÀ¶Ý®ÊÓÆµpQ1 Initial Review Application Title˜ 6> _PID_GUIDäAN{6DD43569-B754-11D9-9676-000476E87EBF} þÿÿÿþÿÿÿþÿÿÿ !"#$%þÿÿÿýÿÿÿ(þÿÿÿþÿÿÿþÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿRoot Entryÿÿÿÿÿÿÿÿ ÀFÀGC‚ }Å@Íckg•Å*€1TableÿÿÿÿÿÿÿÿÿÿÿÿWordDocumentÿÿÿÿÿÿÿÿ*SummaryInformation(ÿÿÿÿDocumentSummaryInformation8ÿÿÿÿÿÿÿÿÿÿÿÿCompObjÿÿÿÿjObjectPoolÿÿÿÿÿÿÿÿÿÿÿÿ@Íckg•Å@Íckg•Åÿÿÿÿÿÿÿÿÿÿÿÿþÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿþÿ ÿÿÿÿ ÀFMicrosoft Word Document MSWordDocWord.Document.8ô9²q