Institutional Biosafety Committee Research Integrity and Compliance Office Research 1-1735 Research Park Drive www.ndsu.edu/ibc Institutional Biosafety Application Questions about this form? Call 231-8908 Submit form to ndsu.ibc@ndsu.edu

IBC USE ONLY Protocol # Review Approval Date
Protocol # Protocol Title Principal Investigator Name This form is for MINOR changes only. If your proposed changes do not fit into one of the categories listed below a new submission in Novelution may be necessary. Please call the IBC office at 231-8908 with questions.
Please select type of change(s) you are requesting from the 5 categories:
☐Personnel Change Research Team and Required Training All research team members should be listed below. Training requirements are based on the agents/materials used in the protocol. Required training courses (www.citiprogram.org) Add Name Role in Protocol Basic Biosafety NIH Recombinant DNA Guidelines OSHA Bloodborne Pathogens Remove Name Role in Protocol Basic Biosafety NIH Recombinant DNA Guidelines OSHA Bloodborne Pathogens Please list the names of individuals that will have routine exposure to human blood, bodily fluids or tissues while working on this project. Name Hepatitis B Vaccine Offered? Choose an item. Choose an item. Choose an item. ☐Title Change The new title for this protocol is: Is the change in protocol due to a new grant submission? Provide grant information below. ☐Yes ☐No

☐Facility Change

Building Location	Room Number	Activity/Use	Biosafety level

Projects that have a containment level of BSL-2 or higher are required to have a laboratory specific Biosafety Manual. In addition, all locations where BSL-2 or higher work is being conducted are required to have the space inspected by the NDSU Biological Safety Officer

☐Risk Group Classification Change

☐Methods and Procedures

Please provide an explanation below of the requested change in methods and procedures.

Procedures- Briefly describe your change is procedures or facility

Please provide an explanation below of the requested change in the risk group classification or methods and procedures.

Additional information - Please include any additional information in the box below.

Institutional Biosafety Committee

The IBC has reviewed and approved this protocol.