Páginas: 2 (420 palabras) Publicado: 4 de diciembre de 2011
May be required for research involving human subjects, vertebrate animals, potentially hazardous biological agents, and DEA-controlled substances. Must be completed and signed before the start ofstudent experimentation.

Qualified Scientist Form (2)

Student’s Name(s) Miriannie Rivera Valerio Title of Project A comparative study on the different types of management techniques used forcontroling high levels of
Attention Deficit Hyperactivity Disorder; medication, behavior management and multimodal techniques.

To be completed by the Qualified Scientist:
Scientist Name: JuanaAltagracia Valerio Lora Educational Background: Family Therapist Degree(s): Masters in Family Therapy Experience/Training as relates to the student’s area of research: Have worked with children who have thecondition Position: Psychologist Institution: Centro Materno San Lorenzo, Dominican Republic Address: Club de Leones 188 Alma Rosa, Dom.Rep Email/Phone:

1) Have you reviewedthe Intel ISEF rules relevant to this project? 2) Will any of the following be used? a) Human subjects b) Vertebrate animals c) Potentially hazardous biological agents (microorganisms, rDNA andtissues, including blood and blood products) d) DEA-controlled substances 3) Will you directly supervise the student? a) b) If no, who will directly supervise and serve as the Designated Supervisor?Experience/Training of the Designated Supervisor:

o Yes o Yes o Yes o Yes o Yes o Yes

o No o No o No o No o No o No

4) Describe the safety precautions and training necessary for this project: Thereare not safety precautions and training necessary for this investigation.

To be completed by the Qualified Scientist:
I certify that I have reviewed and approved the Research Plan prior to thestart of the experimentation. If the student or Designated Supervisor is not trained in the necessary procedures, I will ensure her/his training. I will provide advice and supervision during the...
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