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USC REC F 30 Protocol Package Checklist

This document is a checklist from the University of San Carlos Research Ethics Committee (REC) that lists the required documents for review of a research protocol titled "Knowledge and Behavior of Student Nurses on Patient Safety and Quality in the Nursing Practice in Southwestern University PHINMA". The checklist contains 19 items of mandatory documents that must be submitted for review, including consent forms, the research protocol, budget details, CV's of researchers and advisers, and a receipt form. All listed documents are indicated as being included in the submission.

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Hanniel Caba�og Montecalbo
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99 views3 pages

USC REC F 30 Protocol Package Checklist

This document is a checklist from the University of San Carlos Research Ethics Committee (REC) that lists the required documents for review of a research protocol titled "Knowledge and Behavior of Student Nurses on Patient Safety and Quality in the Nursing Practice in Southwestern University PHINMA". The checklist contains 19 items of mandatory documents that must be submitted for review, including consent forms, the research protocol, budget details, CV's of researchers and advisers, and a receipt form. All listed documents are indicated as being included in the submission.

Uploaded by

Hanniel Caba�og Montecalbo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

University of San Carlos Research Ethics Committee

REC Form No: 30

Protocol Package Checklist Version No. 07-01

Effective Date: 11/19/21

IMPORTANT: The purpose of this checklist is to provide support for USC REC Secretariat conducting screening of submission materials.

Protocol Code:

KNOWLEDGE AND BEHAVIOR OF STUDENT NURSES ON PATIENT SAFETY AND QUALITY IN THE NURSING
Protocol Title: Ver. 1
PRACTICE IN SOUTHWESTERN UNIVERSITY PHINMA

MENDIJAR, PHOEBE BACLIG

MICULOB, JOHN KYLE CAMPOS

MONTECALBO, HANNIEL CABAÑOG

ORTEGA, LEONY MAE OPONG

PACHECO, MARICOR ROQUE

PALANG, DAN CLIFFORD CUANAN

PANGANIBAN, MIKKA ROSE PANUGAN

PICZON, JACKIELYN ROSE P.


Researcher(s)/

Proponent(s):
QUINES, CYNDER KATE ABAO

RALIA, JOY ABIGAIL MORENO

REMOROZA, JESSELLE MAE FUENTES

RUSIANA, MARIA JESSEL ANN LACANGLACANG

TIROL, MARY GRACE MALAYAN

TORNIADO, MITCH NICOLE TORRENUEVA

VALIC, MAE ANN OLIVA

YRAY, AALIYAH
University of San Carlos Research Ethics Committee

REC Form No: 30

Protocol Package Checklist Version No. 07-01

Effective Date: 11/19/21

ITEM NO. MANDATORY DOCUMENTS YES NO NA

1 USC REC F-34 - Data Privacy Consent Form ✓

2 USC REC processing fee ✓

3 Cover Letter ✓

4 USC REC F-31 - Capsule Proposal Template ✓

5 USC REC F-32 - Research Protocol Application Form, duly filled and signed by the Researcher(s)/Proponent(s) ✓

6 USC REC F-22 - Protocol Review Assessment Form ✓

7 USC REC F-23 - Informed Consent Form Assessment Checklist ✓

8 Study Protocol - 1 hard copy ✓

9 Study Protocol - soft copy to be sent by email ✓

10 Informed Consent Form (ICFs) in English and/or, if applicable, dialect spoken and understood by research
✓
participant(s)

11 Assent Form (if applicable) in English and/or dialect spoken and understood by research participant(s) ✓

12 Research instrument (if applicable) ✓

13 Request approval for the use of research instrument(s) (if applicable) ✓

14 USC REC F-33 - Detailed Budget Sheet ✓

15 Signed and dated brief current Curriculum Vitae (CV) of Researcher(s)/Proponent(s) ✓

16 Signed and dated brief current Curriculum Vitae (CV) of Adviser ✓

17 USC REC F-29 - Document Receipt Form (two copies) ✓

18 Amendments, if any ✓

19 Any other documents submitted ✓


University of San Carlos Research Ethics Committee

REC Form No: 30

Protocol Package Checklist Version No. 07-01

Effective Date: 11/19/21

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