REB

The Ottawa Health Science Network Research and Bruyère Continuing Care Research Ethics Board Harmonized Review Process The Ottawa Health Science Network Research and the Royal Ottawa Health Care Group Research Ethics Board Harmonized Review Process
1.	Is this a multicenter study (i.e.: will be conducted at multiple sites in Ontario including both Bruyère/Bruyère RI and TOH/OHRI or UOHI/OHIRC)? Royal Ottawa Health Care Group (ROHCG) and TOH/OHRI or UOHI/OHIRC)?	Yes, multiple sites including Bruyère/Bruyère RI and TOH/OHRI or UOHI/OHIRC Yes, multiple sites including ROHCG and TOH/OHRI or UOHI/OHIRC Yes, only Bruyère/Bruyère RI and TOH/OHRI or UOHI/OHIRC Yes, only ROHCG and TOH/OHRI or UOHI/OHIRC No
1.a.	Is the site Principal Investigator an employee/staff member of both TOH or UOHI and Bruyère The Royal (e.g., cross-appointed research responsible to submit to both REBs)?	Yes No
	Please submit your application through Clinical Trials Ontario (CTO). For more information, please review the CTO website: www.ctontario.ca or contact a representative from one of the REB's listed below: Ottawa Health Science Network Research Ethics Board: http://www.ohri.ca/ohsn-reb/contacts.htm Bruyère Research Ethics Board: https://www.bruyere.org/en/researchethicsboard Royal Ottawa Health Care Group Research Ethics Board: https://www.theroyal.ca/research/about-research/research-ethics-board
	This study does appear to fall under the OHSN-REB & Bruyère-REB ROHCG-REB Harmonization review process. If you require further assistance, please request a huddle meeting via REBAdministration@ohri.ca

9.	Upload the Protocol :
10.	Upload the consent form (if available) :

2.	Name of the person completing this form (First Name, Surname) :
3.	Email address of person completing this form :
4.	Study Title :
5.	Study Acronym (if applicable) :
6.	Will there be study activity at both Bruyère/Bruyère RI and TOH/OHRI or UOHI/OHIRC? Will there be study activity at both ROHCG and TOH/OHRI or UOHI/OHIRC?	Yes No (all research activities are conducted at one site or external site (e.g.: community health centre, University of Ottawa, etc.)
	Indicate the study related activities that will be conducted at Bruyère/Bruyère RI : Indicate the study related activities that will be conducted at ROHCG :	Protocol development Identification of participants Recruitment of participants Obtaining participant consent Study procedures Data collection Sample collection, retrieval and/or transfer Data analysis
	Bruyère/Bruyère RI Principal Investigator’s Name : ROHCG Principal Investigator’s Name :
	Bruyère/Bruyère RI Principal Investigator’s Email : ROHCG Investigator’s Email :
	Indicate the study related activities that will be conducted at TOH/OHRI or UOHI/OHIRC :	Protocol development Identification of participants Recruitment of participants Obtaining participant consent Study procedures Data collection Sample collection, retrieval and/or transfer Data analysis
	TOH/OHRI or UOHI/OHIRC Principal Investigator’s Name :
	TOH/OHRI or UOHI/OHIRC Principal Investigator’s Email :
	At which site will the research activities be conducted?	TOH/OHRI or UOHI/OHIRC Bruyère/Bruyère RI ROHCG Other (e.g.: Community Health Centre, University of Ottawa, etc.) Specify other site : Specify the primary research appointment of Principal Investigator : TOH/OHRI or UOHI/OHIRC Bruyère/Bruyère RI ROHCG
	Principal Investigator's Name (First Name Surname) :
	Principal Investigator's Email Address :
	Does the Principal Investigator hold a research appointment at both OHRI or OHIRC and Bruyère RI? Does the Principal Investigator hold a research appointment at both OHRI or OHIRC and ROHCG? Note, OHRI affiliation does not permit ROHCG personnel to conduct research at OHRI.	Yes No, OHRI or OHIRC only No, Bruyère RI only No, ROHCG only ROHCG and OHRI cross appointment ROHCG and OHIRC cross appointment
7.	Does the study involve minimal risk or greater than minimal risk?	Minimal riskGreater than minimal risk
8.	Provide a brief synopsis of the study, including brief description of study objectives :