cell/telephone number / transportation / drug or device / research protocol / /
MedicalTreatment
radiation / /
Movie
CONFLICT OF INTEREST / /
Organization
National Drug Authority / P.I Current Qualifications Academic Title Institution / Institutional Review Board / Ethical Review Committee / Biomedical Sciences Research and Ethics Committee Makerere University College / Institutional Ethical Review Board / Biomedical Sciences Research and Ethics committee / School of Biomedical Sciences Research and Ethics / Ethics committee / Co-investigators Names/Supervisors Qualifications Institution / OFFICIAL STAMP OF INSTITUTION / Funding / School of Biomedical Sciences Research / Signature Ethics Committee / /
Position
investigator / representative / SIGNATURE ASSURANCE SHEET Principal Investigator / consultant / Chairman / PRINCIPAL INVESTIGATOR / Secretary / Head / Co-investigator / /