Microsoft Word - Protocol_For_Animal_Use



STOCKTON UNIVERSITYINSTITUTIONAL ANIMAL CARE AND USE COMMITTEEProtocol For Animal UseFor Committee Use Only IACUC# Date of Submission:Name of Principal Investigator:Radioisotope material Carcinogens/controlled drugs Hazardous Waste Collaborating institution Field research only Approval by Biosafety Committee Proposal Title:Forelimb movements during bipedal locomotion in lizardsStatus:( ) New( ) Renewal( ) ModificationAnimal Species:Anticipated beginning date:If project does not start within one month of the anticipated beginning date, notifyInstitutional Animal Care and Use Committee (IACUC)Anticipated ending date:After one year, send status report to IACUC (research project only)Research Category:( ) Instruction-related( ) Nonfunded(If applicable)( ) Funded( ) GrantCollaborations and Subcontracted Research – Attach a copy of a signed Institutional Animal Care and Use Committee (IACUC) protocol from the collaborative institution. The signed protocol from the collaborative institution will be reviewed by the Stockton IACUC. Reference: NIH IACUC Guidebook pg. 22-25Overview1.Describe briefly the purpose of the study, experimental procedures and manipulations of the animals, and the expected outcome in lay terms. Summarize in narrative form the procedures and manipulations to be performed using animals, and explain why they are performed. If you need additional space, attach pages.a.Describe clearly and in lay terms the benefits expected to be gained from this study.b.Describe any progress or previous experiments that are applicable to this proposal.2. Personnel and qualifications: Give the name(s) of all individual(s) who will work with the animals in this study. Describe their education, pertinent certification, training and relevant experience with experimental animals. This must enable reviewers to determine that manipulations of animal subjects are performed by individuals who are qualified to accomplish the procedures skillfully and humanely. Provide curriculum vitae’s for all personnel handling animals. If personnel do not have experience, specify what training will be given, by whom, and how the training is to be provided.3.Animal characteristics.This information must be filled out for each species to be used. Strain/Stock/Mutant/Breed: Scientific Name Common NameWild-typeSex:( ) Male( ) Female( ) Both or EitherMicrobial Status:Strain/Stock/Mutant/Breed: Scientific Name Common NameWild-typeSex:( ) Male( ) Female( ) Both or Either4.Animal housing location:a.Description of housing (include dimensions):Reference: Animal Welfare Act Subpart A, Subpart Bb.Total number of animals to be used:c.Justify the number of animals needed for the study:5.Provide the name (and title) of the veterinarian or the institutional resource responsible for providing veterinary care to the animals.Reference: Animal Welfare Act 2144f, Subpart D6.Location where experimental procedures will be performed:Laboratory research: Field research: 7.Check any of the following agents utilized in the experiment: N/A infectious carcinogens experimental drugsa. to humansb. to animals toxic chemicals radioisotope materials noxious gasesAgent: Recombinant DNA (Class-I, II, III, IV, V) tumor cells, tissues, sera and other biologics that may contain infectious agents.Describe items checked above:Check no if none of the agents listed above will be used in the experiment Yes No8.Will anesthetic agents be used during any portion of these animal studies? Yes NoIf yes, describe anesthetic agent.9.Will survival surgery be performed as part of the experimental protocol? Yes NoIf yes, describe the procedure and the qualifications of the surgeon(s).10.What will be done with the animals when the experiment is concluded?Animals may not be given to other investigators without approval by theIACUC.11.If euthanasia is the method of disposal:11a.Name the chemical agent(s), which will be used.11b.Name the physical method, which will be used.12.Will the procedure(s) to be employed have the potential to cause pain or distress? Yes NoIf yes, describe appropriate sedatives, analgesics or anesthetics. If yes, also describe alternative procedures.13.Will drugs classified as controlled substances be used in this study? Yes NoIf yes, list the controlled substances that will be used.All controlled substances must be stored in a locked cabinet and accessible only to authorized persons.14.Are there any permits (federal, state and/or local) needed for the possession of the animals in this protocol? Yes NoAttach a copy of permit. It is the responsibility of the Principal Investigator to renew the permits each year and provide a copy of the permit to the IACUC committee.Reference: New Jersey Division of Fish, Wildlife and Game15.Will hazardous waste be generated during this project? Yes NoIf yes, give a description of the hazardous waste.Reference: 40CFR 262-268, NIH IACUC Guidebook pg. 138-14116.Does a NAMS Laboratory Research Form need to be filled out for this project? Yes NoNAMS laboratory Research Forms are located in F00117.Certification by Principal InvestigatorI certify that these studies do not unnecessarily duplicate previous experiments. I further affirm that, to the best of my knowledge, information provided in this Protocol for Animal Use request is complete and accurate, and that no significant changes will be made without advance approval of the IACUC. I also certify that my staff has both the appropriate experience and/or training to perform this protocol.SignatureDate18.Approval SignaturesThe undersigned have evaluated the care and use of animals described in this protocol in accordance with the provisions of the Animal Welfare Act, Guide for the Care and Use of Laboratory Animals, and find that the procedures described are appropriate and acceptable.SignatureDateSignatureDateSignatureDateSignatureDateSignatureDate19. Comments and dissenting views. (Dissenting views, if any, must be recorded here.) ................
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