MULTIPLE PROJECT ASSURANCE OF COMPLIANCE WITH DHHS REGULATIO

****************************************************************************** FOR DHHS USE ONLY II. Office for Protection from Research Risks (DHHS) Approval (see Appendix C) A. DHHS RECOMMENDING OFFICIAL Signature: Date: Name: Katherine Duncan, M.D. Title: Adjunct Medical Officer Address: Division of Human Subject Protections Office for Protection from Research Risks (OPRR) 6100 Executive Boulevard, Room 3BO1 (MSC 7507) Rockville, Maryland 20892-7507 Phone: 301- 496-7005 X207 Fax: 301- 402-0527 E-Mail: kd41f@nih.gov

EFFECTIVE DATE OF ASSURANCE: __________________ EXPIRATION DATE OF ASSURANCE: _________________

B.

DHHS APPROVING OFFICIAL Signature:

Date: ___________

Name: Title:

_________________________

Assurance Coordinator , Assurance Branch Division of Human Subject Protections Office for Protection from Research Risks (OPRR) 6100 Executive Boulevard, Room 3BO1 (MSC 7507) Rockville, Maryland 20892-7507

Address:

301- 496-7041 X 301- 402-0527

Phone:

Fax:

E-Mail

____________