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Reed IRB incident report
Fill out the following form to report an incident arising during human subjects research conducted by one or more members of the Reed College community. This form will be read by the chair and admin of the Institutional Review Board (IRB). Depending on how you respond to the following questions, it may also be shared with the full IRB and/or the researcher(s).
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* Indicates required question
Which research project were you a participant in? You can provide either the name(s) of the researcher(s), the name of the project itself, and/or a brief description of the project.
*
Your answer
Which of the following issues arose during the research project you participated in? (Check all that apply)
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The researcher(s) did not explain the procedure clearly
The researcher(s) did not clearly ask for my consent
The researcher(s) did not respect my sense of privacy
The researcher(s) did not follow through with what they told me they would do
The researcher(s) offended and/or hurt me
The researcher(s) acted in an unprofessional and/or inappropriate manner
The researcher(s) subjected me to tasks I did not want to participate in
Other:
Required
Describe the specific issue you'd like to report, making sure to include details of what struck you as inappropriate, unclear, or discomforting.
Your answer
Would you like the Institutional Review Board (IRB, i.e. the committee that oversees the treatment of research participants) to talk with the researcher(s) about this report?
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Yes, and all details can be shared
Yes, with identifying details left out
No
Other:
Would you like a response from members of the Institutional Review Board (IRB)?
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Yes (provide email address under the final question)
No
Would you like a response from the researcher(s)?
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Yes (provide email address under the final question)
No
Other:
Please provide your email address for a response, if you've checked "yes" to either of the two preceding questions.
Your answer
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