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Indemnity

For studies conducted by a third party, the third party is requested to indemnify the hospital and provide a current certificate of insurance.

When The Royal Victorian Eye and Ear Hospital is not a site and the Eye and Ear's Human Research Ethics Committee (HREC) is providing HREC review only, the HREC Review only Form will apply.

Forms

When The Royal Victorian Eye and Ear Hospital is an investigational site:

Standard Form of Indemnity for clinical trials involving a medicinal product.

Standard Form of Indemnity for clinical trials involving a device.

When The Royal Victorian Eye and Ear Hospital is not a site and the Eye and Ear's Human Research Ethics Committee (HREC) is providing HREC review only, the HREC Review Only Form will apply.

HREC Review only for clinical trials involving a medicinal product.

HREC Review Only for clinical trials involving a device.

 

Eye and Ear site specific requirements

Where appropriate, please use the following information to populate the forms:

  • To: The Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, Victoria, 3002
  • ABN: 81 863 814 677
  • In clause 1, use only one of the following bracketed terms; either
    • {patients of the Indemnified Party}; or
    • {non-patient volunteers}
  • In clause 1, [name of investigator(s)] please list the  names of all Principal Investigators (title, first name and surname).

Do not add in any other words or phrases.

Signatures

Submit two hard copies of the documentation to the Research Office and we will organise the relevant signatures from the Eye and Ear Hospital.

The Sponsor must have signed the Form of Indemnity before submitting it to the Eye and Ear Hospital.

Further information

For assistance with indemnity and insurance documentation, please contact the Research Office.

Last updated 25 March 2020