{"id":1330,"date":"2022-03-07T15:46:34","date_gmt":"2022-03-07T06:46:34","guid":{"rendered":"https:\/\/www.kyorin-u.ac.jp\/univ\/faculty\/medicine\/_manage\/?page_id=1330"},"modified":"2025-08-01T16:19:55","modified_gmt":"2025-08-01T07:19:55","slug":"form","status":"publish","type":"page","link":"https:\/\/www.kyorin-u.ac.jp\/univ\/faculty\/medicine\/ethics\/form\/","title":{"rendered":"\u7533\u8acb\u69d8\u5f0f"},"content":{"rendered":"<section class=\"BlkArticle__Contents--notLead\">\r\n  <p>\u5404\u69d8\u5f0f\u306e Microsoft Word \u6587\u66f8\u30d5\u30a1\u30a4\u30eb \u3092\u30c0\u30a6\u30f3\u30ed\u30fc\u30c9\u3057\u3066\u3054\u5229\u7528\u304f\u3060\u3055\u3044\u3002<\/p>\r\n  <p>\u203b \u300c\u4eba\u3092\u5bfe\u8c61\u3068\u3059\u308b\u751f\u547d\u79d1\u5b66\u30fb\u533b\u5b66\u7cfb\u7814\u7a76\u306b\u95a2\u3059\u308b\u502b\u7406\u6307\u91dd\u300d\u306e2021\u5e746\u670830\u65e5\u65bd\u884c\u306b\u4f34\u3044\u3001\u5404\u69d8\u5f0f\u3092\u6539\u8a02\u3044\u305f\u3057\u307e\u3057\u305f\u3002\uff08\u7b2c6\u53f7\u3001\u7b2c16\u53f7\u3001\u7b2c18\u53f7\u3092\u9664\u304f\uff09\uff082021\u5e746\u670829\u65e5\uff09<\/p>\r\n    <p>\u203b \u300c\u4eba\u3092\u5bfe\u8c61\u3068\u3059\u308b\u751f\u547d\u79d1\u5b66\u30fb\u533b\u5b66\u7cfb\u7814\u7a76\u306b\u95a2\u3059\u308b\u502b\u7406\u6307\u91dd\u300d\u306e2022\u5e743\u670810\u65e5\u4e00\u90e8\u6539\u6b63\u306b\u4f34\u3044\u3001\u7b2c18\u53f7\u3001\u7b2c19\u53f7\u3092\u6539\u8a02\u3044\u305f\u3057\u307e\u3057\u305f\u3002\uff082023\u5e743\u670824\u65e5\uff09<\/p>\r\n<div class=\"table__mask\">\r\n    <table width=\"100%\" class=\"BlkArticle__tableNormal BlkArticle__tableNormal--topLeft\">\r\n      <thead>\r\n        <tr>\r\n          <th class=\"cellHeading\" scope=\"col\" width=\"20%\"><span>\u69d8\u5f0f<\/span><\/th>\r\n          <th class=\"cellHeading\" scope=\"col\" width=\"80%\"><span>\u69d8\u5f0f\u540d\u79f0<\/span><\/th>\r\n        <\/tr>\r\n      <\/thead>\r\n      <tbody>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c&nbsp;1\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_01-05.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u7814\u7a76\u502b\u7406\u5be9\u67fb\u7533\u8acb\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span> <br>\r\n            <a href=\"http:\/\/www3.kyorin-u.ac.jp\/igakujimu\/ethics_4.html\" class=\"u-icon_jump\">\u203b \u53d7\u8b1b\u756a\u53f7\u306e\u78ba\u8a8d\u306f\u3053\u3061\u3089\u304b\u3089\uff08\u5b66\u5185\u5c02\u7528\u30b5\u30a4\u30c8\uff09<\/a><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c&nbsp;6\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_06.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u7570\u8b70\u7533\u7acb\u66f8<\/a><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c&nbsp;8\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_08.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u7814\u7a76\u8a08\u753b\u5909\u66f4\u7533\u8acb\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span> <br>\r\n            <a href=\"http:\/\/www3.kyorin-u.ac.jp\/igakujimu\/ethics_4.html\" class=\"u-icon_jump\">\u203b \u53d7\u8b1b\u756a\u53f7\u306e\u78ba\u8a8d\u306f\u3053\u3061\u3089\u304b\u3089\uff08\u5b66\u5185\u5c02\u7528\u30b5\u30a4\u30c8\uff09<\/a><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c&nbsp;9\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_09.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u7814\u7a76\u5b9f\u65bd\u72b6\u6cc1\u5831\u544a\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c10\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_10.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u7814\u7a76\u7d42\u4e86\u30fb\u4e2d\u6b62\u5831\u544a\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c11\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_11.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u5b89\u5168\u6027\u60c5\u5831\u306b\u95a2\u3059\u308b\u5831\u544a\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c12\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_12.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u306b\u95a2\u3059\u308b\u5831\u544a\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c12-1\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_12-1.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u306b\u95a2\u3059\u308b\u5831\u544a\u66f8\uff08\u533b\u85ac\u54c1\uff09<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c12-2\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_12-2.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u306b\u95a2\u3059\u308b\u5831\u544a\u66f8\uff08\u533b\u85ac\u54c1\uff09\u8a73\u7d30\u8a18\u8f09\u7528<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c12-3\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_12-3.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u53ca\u3073\u4e0d\u5177\u5408\u306b\u95a2\u3059\u308b\u5831\u544a\u66f8\uff08\u533b\u7642\u6a5f\u5668\uff09<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c13\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_13.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u4ed6\u306e\u7814\u7a76\u6a5f\u95a2\u306b\u304a\u3044\u3066\u767a\u751f\u3057\u305f\u591a\u6a5f\u95a2\u5171\u540c\u7814\u7a76\u306b\u95a2\u9023\u3059\u308b\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u306b\u95a2\u3059\u308b\u5831\u544a<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c14\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_14.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u751f\u547d\u79d1\u5b66\u30fb\u533b\u5b66\u7cfb\u7814\u7a76\u306b\u95a2\u3059\u308b\u502b\u7406\u6307\u91dd\u4e0d\u9069\u5408\u306b\u95a2\u3059\u308b\u5831\u544a\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c15\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_15.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u30fb\u76e3\u67fb\u5b9f\u65bd\u8a08\u753b\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c16\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_16.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u30fb\u76e3\u67fb\u306b\u304a\u3051\u308b\u5b88\u79d8\u7fa9\u52d9\u8a93\u7d04\u66f8<\/a><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c17\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_17.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u30fb\u76e3\u67fb\u5b9f\u65bd\u5831\u544a\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c18\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/uploads\/2023\/03\/\u69d8\u5f0f\u7b2c\uff11\uff18\u53f7_\u4ed6\u306e\u7814\u7a76\u6a5f\u95a2\u3078\u306e\u8a66\u6599\u30fb\u60c5\u5831\u306e\u63d0\u4f9b\u306b\u95a2\u3059\u308b\u5831\u544a\u66f8.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u4ed6\u306e\u7814\u7a76\u6a5f\u95a2\u3078\u306e\u8a66\u6599\u30fb\u60c5\u5831\u306e\u63d0\u4f9b\u306b\u95a2\u3059\u308b\u8a18\u9332<\/a>\r\n&nbsp;<span class=\"dateup\">2023.03.24 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c19\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/uploads\/2023\/03\/\u69d8\u5f0f\u7b2c\uff11\uff19\u53f7_\u4ed6\u306e\u7814\u7a76\u6a5f\u95a2\u3078\u306e\u8a66\u6599\u30fb\u60c5\u5831\u306e\u63d0\u4f9b\u306b\u95a2\u3059\u308b\u5c4a\u51fa\u66f8.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u4ed6\u306e\u7814\u7a76\u6a5f\u95a2\u3078\u306e\u8a66\u6599\u30fb\u60c5\u5831\u306e\u63d0\u4f9b\u306b\u95a2\u3059\u308b\u5c4a\u51fa\u66f8<\/a> \r\n&nbsp;<span class=\"dateup\">2023.03.24 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c20\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/form_20.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u4e2d\u592e\u4e00\u62ec\u502b\u7406\u5be9\u67fb\u59d4\u8a17\u7533\u8acb\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u69d8\u5f0f\u7b2c20-1\u53f7<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/uploads\/2025\/02\/form_20-1.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u4e2d\u592e\u4e00\u62ec\u502b\u7406\u5be9\u67fb\u7d50\u679c\u5c4a\u51fa\u66f8<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n          <tr>\r\n          <th>\u53c2\u8003\u8cc7\u6599<\/th>\r\n          <td><a href=\"http:\/\/www3.kyorin-u.ac.jp\/igakujimu\/coi.html\" class=\"u-icon_jump\">\u533b\u5b66\u7cfb\u7814\u7a76\u306b\u4fc2\u308b\u5229\u76ca\u76f8\u53cd\u81ea\u5df1\u7533\u544a\u66f8\uff08\u5b66\u5185\u5c02\u7528\u30b5\u30a4\u30c8\uff09<\/a><\/td>\r\n        <\/tr>\r\n\u3000\u3000\u3000\u3000\u3000<tr>\r\n          <th>\u53c2\u8003\u8cc7\u6599<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/uploads\/2025\/08\/consent-form_sample.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u8aac\u660e\u6587\u66f8\uff08\u30b5\u30f3\u30d7\u30eb\uff09<\/a> &nbsp;<span class=\"dateup\">2025.08.01 up<\/span><\/td>\r\n        <\/tr>\r\n\u3000\u3000\u3000\u3000\u3000<tr>\r\n          <th>\u53c2\u8003\u8cc7\u6599<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/uploads\/2025\/08\/optout_sample.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u30aa\u30d7\u30c8\u30a2\u30a6\u30c8\uff08\u30b5\u30f3\u30d7\u30eb\uff09<\/a> &nbsp;<span class=\"dateup\">2025.08.01 up<\/span><\/td>\r\n        <\/tr>\u3000\u3000\u3000\u3000\u3000\r\n\u3000\u3000\u3000\u3000\u3000<tr>\r\n          <th>\u53c2\u8003\u8cc7\u6599<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/doisho_sample.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u540c\u610f\u66f8\uff08\u6307\u5b9a\u69d8\u5f0f\uff09<\/a> &nbsp;<span class=\"dateup\">2021.06.29 up<\/span><\/td>\r\n        <\/tr>\r\n\u3000\u3000\u3000\u3000\u3000<tr>\r\n          <th>\u53c2\u8003\u8cc7\u6599<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/uploads\/2025\/08\/doitekkai_sample.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u540c\u610f\u64a4\u56de\u66f8\uff08\u30b5\u30f3\u30d7\u30eb\uff09<\/a> &nbsp;<span class=\"dateup\">2025.08.01 up<\/span><\/td>\r\n        <\/tr>\r\n      <\/tbody>\r\n    <\/table>\r\n  <\/div>\r\n  <p>\u89e3\u5256\u4f53\u3092\u7528\u3044\u305f\u7814\u7a76\u306e\u5834\u5408\u306f\u4ee5\u4e0b\u306e\u69d8\u5f0f\u3092\u30c0\u30a6\u30f3\u30ed\u30fc\u30c9\u3057\u3066\u3054\u5229\u7528\u304f\u3060\u3055\u3044\u3002<\/p>\r\n  <div class=\"table__mask\">\r\n    <table width=\"100%\" class=\"BlkArticle__tableNormal BlkArticle__tableNormal--topLeft\">\r\n      <thead>\r\n        <tr>\r\n        <tr>\r\n        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href=\"\/univ\/faculty\/medicine\/uploads\/2025\/04\/kenkyukeikaku_kaibotai_sample-2025.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u7814\u7a76\u5b9f\u65bd\u8a08\u753b\u66f8\uff08\u89e3\u5256\u4f53\u3092\u7528\u3044\u305f\u7814\u7a76\uff09<\/a><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u53c2\u8003\u8cc7\u6599<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/johokokai_kaibotai_sample.xlsx\" class=\"u-icon_xls\" target=\"_blank\" rel=\"noopener\">\u60c5\u5831\u516c\u958b\u6587\u66f8\uff08\u89e3\u5256\u4f53\u3092\u7528\u3044\u305f\u7814\u7a76\uff09<\/a><\/td>\r\n        <\/tr>\r\n        <tr>\r\n          <th>\u53c2\u8003\u8cc7\u6599<\/th>\r\n          <td><a href=\"\/univ\/faculty\/medicine\/asset\/pdf\/doitekkai_kaibotai_sample.docx\" class=\"u-icon_doc\" target=\"_blank\" rel=\"noopener\">\u540c\u610f\u64a4\u56de\u66f8\uff08\u89e3\u5256\u4f53\u3092\u7528\u3044\u305f\u7814\u7a76\uff09<\/a><\/td>\r\n        <\/tr>\r\n      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