Page 86 - NATIONAL INSTITUTES OF HEALTH (NIH) GUIDELINES FOR CONDUCTING RESEARCH IN MINISTRY OF HEALTH (MOH) INSTITUTIONS & FACILITIES 3RD EDITION 2021

APPENDIX 7: IBBC Study Declaration Form

IMR INSTITUTIONAL BIOSAFETY & BIOSECURITY COMMITTEE (IMR IBBC)
PRELIMINARY ASSESSMENT FORM
INSTITUTE FOR MEDICAL RESEARCH MALAYSIA
Email: ibbcsecretariat@moh.gov.my

INSTRUCTION :
For activities involving the use of infectious and potentially infectious agents/materials and biological
toxins in their natural unmodified and genetically modified. Preliminary assessment form is used to
identify new proposal(s) or activity. Submission is to be made by email and accompanied by an
original signed document to IMR-IBBC Secretariat.
SECTION A : PRINCIPAL INVESTIGATOR’S (PI’s)/HEAD OF DEPARTMENT (HOD) INFORMATION
Name
Unit
Centre
Office Mobile No
Phone No
Email

SECTION B : PROJECT INFORMATION
1. Purpose: (Please Tick ) Research
Teaching
Lab Service
Consultancy
Others (Please specify):
2. Project / Activity Title:

3. JPP-IMR No / NMRR No.
4. Duration:
(Please Attached Gantt chart)

5. Project Status: New
(Please Tick )
Ongoing
Funded
6. Collaboration Project: Name of University/ Research
Institute /Industry/ NGO :
(Please State)
Grant No:
(If available)
Funders:

Note:
Please email the complete document to ibbcsecretariat@moh.gov.my within 14 working days from
notifiaction date.
IMR/IBBC/01
Version : 1.0
Date : 20.05.2021 Page 1 of 3

70 NIH Guidelines for Conducting Research in MOH, 2021