TELEPHONE: (607) 777-3818
HUMAN SUBJECTS RESEARCH REVIEW FAX: (607) 777-5025
ITC – ALPHA 2205 E-MAIL: firstname.lastname@example.org
BINGHAMTON, NY 13902-6000
Protocol Closure Form
Instructions: Please complete this form when an approved human subject’s research project is completed or ends
for any reason. Once this form is submitted, data cannot be collected. If you continue to collect follow-up data
(from subjects or existing records) the study should remain opened even if new subjects are not being enrolled.
If any of the following four items are not checked, the research has to continue to undergo continuing review.
The research is permanently closed to enrollment
All subjects have completed all research-related interventions
Collection of private identifiable information is completed
Analysis of private identifiable information is completed
Final Closure of Project: Date:
Project Not Conducted or Cancelled:
Protocol Director no longer at Binghamton University
Location of signed Informed Consent Documents:
Original Approval Date:
Number of Subjects Enrolled:
Principal Investigator (PI):
Advisor (if student project):
PLEASE INCLUDE FINDINGS AND A BRIEF FINAL SUMMARY OF THE PROJECT WITH THIS FORM.
Principal Investigator Signature Date
Reminder: The Principal Investigator is required by the University and Federal regulations to maintain records of all correspondence relating to
the use of human subjects in research. Copies of the application forms, notices of approval, and signed informed consent documents must be
maintained in the Investigator’s records. Copies of these records must be kept for three years after the close of the study, irrespective of the
reason for closing the study. Studies that involve drugs or devices seeking FDA approval must be kept for two years after the FDA has taken
final action on the marketing application. All records of human subject research are subject to inspection by Federal authorities and the HSRRC.