IRB CERTIFICATION OF TRANSLATION FORM
IRB CERTIFICATION OF TRANSLATION FORM
For Translation of Documents into a Language other than English
(Submit Translated Documents with this Form)
IRB Protocol No.:
FOR ORIGINAL TRANSLATION
Title of Research Project:
Name of Principal Investigator:
Language Translated Into:
Title of Each Document Translated:
Name of Person Who Completed Original Translation:
Street Address:
City, State, Zip Code:
I hereby certify that I am the person who did the attached original translation; I will not be involved in doing the “back translation” of the document(s). The attached translation is accurate to the best of my abilities.
Signature of Original Translator: Date:
Printed Name:
FOR “BACK TRANSLATION” INTO ENGLISH
Title of Research Project:
Name of Principal Investigator:
Title of Each Document Back Translated into English:
Name of Person Who Completed "Back Translation”:
Street Address:
City, State, Zip Code:
I hereby certify that I am the person who did the attached "back translation" into English; I was not involved in the original translation of the document. The attached "back translation" is accurate to the best of my abilities. Though I may have received compensation for performing the "back translation," I am not affiliated with the above-titled research project, which I understand would constitute a "Conflict of Interest."
Signature of “Back Translator” Date:
Printed Name:
................
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