Ethics Submission Form

Please click the "Save and Complete Later" link at the bottom of this page to save your progress at any time.



New Study for Approval

Please check all that apply.


As per the Administrative Fee Schedule from the current SJGHC Research Handbook, a one-off fee is to be paid at the time of initial submission to the SJGHC HREC. Please enter details below for the SJGHC Ethics Office to issue a tax invoice for this fee.


"Private Consulting Rooms" are affiliated with SJGHC where a person is accredited to a SJGHC hospital, whereas "External Site/s" are unaffiliated with SJGHC

Where a study does not involve a SJGHC site in any research activity, SJGHC does not assume responsibility for the site-specific authorisation of the research. The SJGHC Human Research Ethics Committee will provide ethical oversight of the progress of the study only.


Ethical Issues


Please consult  Section 2.3.9 and 2.3.10  of the National Statement


Please consult  Section 4.2.6  of the National Statement


Please consult Section  2.3.5 and 2.3.6  of the National Statement


Please consult  Chapter 4.4  of the National Statement


Please consult  Section 4.5.5 to 4.5.11  of National Statement


Please refer to the relevant state consent/guardianship laws where this study will be conducted, and contact the SJGHC Ethics Office


Please consult this document for guidelines involving research with Aboriginal and Torres Strait Islander Peoples


Waiver of Consent

e.g. Medical records of all patients who received Treatment X at Hospital Y between Date A and Date B
e.g. Patients who received Treatment X at Hospital Y between Date A and Date B
e.g. WebPAS, hospital medical files
e.g. Australian Clinical Laboratories, SJG Subiaco Hospital
e.g. demographic data, pathological response
e.g. FFPE tumour tissue blocks
Before deciding to waiver the requirement for consent to research, the HREC must be satisfied that the following requirements are met:

Section 95A of Privacy Act

Australian Privacy Principles relevant to this submission

What considerations are involved in weighing the public interest in the proposed project against the public interest in the protection of privacy?
c) The research is likely to contribute to:
e) In particular, the research will lead to benefits for:
i) The data being sought are usually available to the public from the organisation that holds the data:
k) The standards of conduct that are to be observed in the research, including:

Opt Out Approach to Consent

When it is feasible to contact some or all participants, but where the research is of such scale and significance that using explicit consent is neither practical nor feasible, an Opt Out approach to participant recruitment may be appropriate. The HREC must be satisfied that the following requirements are met to justify an opt-out consent:


Cognitive Impairment

People with a cognitive impairment include those with an intellectual disability or mental illness. The capacity of these people to consent to research and ability to participate will vary, so research should take into account the often "more than usual" vulnerability of these people and minimise potential forms of discomfort and stress. 

As per the National Statement on Ethical Conduct in Human Research (NHMRC, 2023) “NS”, Chapter 4.5, the researcher should address the following in the study submission:


People Highly Dependent on Medical Care

People highly dependent on care may include those who are in intensive care (ICU)/neonatal ICU, emergency, palliative care, or are unconscious. Consent should be sought from people highly dependent on care wherever they are capable of giving consent and it is practicable to approach them. When the impaired capacity is NOT transient OR it is NOT practicable to seek delayed consent, then consent should be sought from the participant's guardian or person or organisation authorised by law.

When neither the potential participant not another on his/her behalf can consider the proposal and give consent, a HREC may, having taken account of relevant jurisdictional laws, approve a research project without prior consent if the following conditions are met:


Update to Previously Approved Study


SRC Update

If the type of update is not listed above, please select HREC as the committee that will review the update.


HREC Update

If you are submitting a Final Report, please select the  SRC as the Committee that will review the submission.

Please attach an amended PSOA.

Please note: Only changes in Investigators require seperate notification to the Committee.  Please submit all other staffing changes in the next Annual Report

Please note: All proposed protocol amendments, extension requests and changes to study investigators must first be
discussed with the Participating Site before being submitted for ethics approval. Please contact the Participating Site prior to this submission

Please complete and submit an Annual Report by selecting "Annual Report" in the "Type of HREC Update" list above.

Please attach the following documents to your submission: 

  1. Participating Site Operational Approval form for the new site (if SJGHC)
    OR letter confirming governance approval for the new site (if external)

  2. current CV and signed Declaration of Interest for the proposed Principal Investigator at the new site

  3. signed Privacy Declaration if the PI is an external researcher


Local SAE/SUSAR/USADE




As per the SJGHC Research Handbook, unrelated Local SAEs are not required to be submitted to the SJGHC HREC.


Serious Breach Report


Please ensure any Serious Breach that occurs at a SJGHC site or involves SJGHC participants or data
is also immediately recorded in Riskman as an incident.

For all local privacy/data breaches, please also escalate and complete mandatory notifications
as per SJGHC policy: GO GRC03 Privacy Data Breach and My Health Record Data Breach Framework and Response Plan.




Annual/Interim Report

Final Report

As per the ethics approval letter or extension date if approved by the SJGHC HREC

As the study is now completed, please amend this form from an Annual Report (for HREC review) to a Final Report (for SRC review).

The consent process may be explicit or implied, e.g. as with the completion of a study questionnaire, written or verbal, extended consent, unspecified consent such as generic consent for future research, substitute consent, delayed consent, opt out consent, etc.


Please submit the current insurance certificate to the SJGHC HREC.

How many publications and/or presentations have arisen from this research?

Please forward the details of any pending publications to the SJGHC Ethics Office once they have been finalised.

Please forward the details of any pending presentations to the SJGHC Ethics Office once they have been finalised.


Publications

Please add details for all publications in the table below.


Presentations

Please add details for all presentations in the table below.


Results

If a study recommends change in practice it must have translation of results. Please amend your response.

Please attach a copy of the findings provided to study participants.




Expedited Review Checklist

"More than Low Risk" research which has previously been approved by an  NHMRC Certified hospital-based HREC  may be approved via an expedited review pathway if it meets the criteria specified below. The research will then be reviewed out of session or tabled directly at the next SJGHC HREC meeting for expedited review, depending on the timing of the submission.


Low Risk Checklist

Prior study approval is required from WAAHEC for studies involving Aboriginal people and from DDVA HREC for studies involving veterans

More than Low Risk Checklist

Prior study approval is required from WAAHEC for studies involving Aboriginal people and from DDVA HREC for studies involving veterans

Attachments

Please list all attached documents in the table below. 

Please list all attached documents in the table below. 

If your submission includes an amendment to a previously approved document (e.g. protocol, PICF) please ensure that you attach both a clean and tracked changes copy.


Browse
All documents must be in PDF format


Please ensure that site CEO, DMS and research office (if applicable) are copied in to this submission. 

Please also ensure that the serious breach is entered into RiskMan.


Draw signature|Type signatureClear

Please ensure that the Participating Site CEO/Director, Participating Site Research Office
and the CPI / any other SJG site investigators (if applicable) are copied in on this submission.


Submission Form Version 1.1 dated July 2025