Epic Research Study Record Change Request Form Epic Research Study Record Change Request Form Heading link Copy link Name of Person Completing Form: * Required Phone Number: Email * Required UIC IRB protocol number: * Required RSH field change is requested for: Principal Investigator (PI) Sponsor (may impact funding agency) Protocol Status Change from Billing Active to Completed Change to: PI Name * RequiredRequires IRB approval documentation to be submitted with change request Change to: Sponsor * RequiredRequires IRB approval documentation to be submitted with change request Reason for change request: All associated charges are cleared, the research is permanently closed to the enrollment of new subjects; AND all subjects have completed all research-related interventions; AND the research remains active only for long-term follow-up of subjects. (Long-term follow-up refers to collection of data on survival or disease status. It does not include data collection activities such as interviews, clinic visits, lab tests, etc.) All associated charges are cleared, data collection is complete, and the study is only open for data analysis Study is Terminated/Completed (requires IRB acknowledgement documentation to be submitted with change request)