Short descriptive title of the incident (e.g., Lost laptop in dept. X).
Brief description of what happened.
Where were people physically located when data were originally collected, if known (Washington State, other states, United States, and/or other countries)?
What system(s), if any/if known, are involved?
Does the incident involve human subjects? Human subjects are defined as living individuals about whom an investigator (whether professional or student) is conducting research: (i) obtains information or biospecimens through intervention or interaction with the individual, and uses, studies, or analyses the information or biospecimens, or (ii) obtains, uses, studies, analyzes, or generates identifiable private information or identifiable biospecimens?
If the incident has been reported to the UW IRB include the RNI#.
Provide the full name of the IRB without acronyms.
Please list the names and organizations for the other individuals who have been informed about this incident.
What is the root cause of the incident, if known?