Fillable Animal Use Form (Alabama A&M University)

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Animal Use Form (Alabama A&M University)

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Institutional Animal Care and Use Committee
(IACUC)
Review of Protocol by the Institutional Animal Care and Use Committee
Please attach a copy of the proposal
Animals:
Species:
Breed:
Age:
Sex:
Source:
Duration of Experiment:
Housing:
Galvanized wire cages:
Cage Size:
Plastic cages:
Other (Specify):
No. of animals per cage:
Restraints:
Location of Cages:
Temp. & Humidity control: Yes
No
Husbandry:
Type of bedding:
Lighting schedule:
Feeding schedule:
Watering system:
Watering schedule:
Surgery:
Type of surgery:
Surgeon:
Post-surgical care:
Pain/Distress:
Surgery
Biopsy
Burning
Freezing
Branding
Fracturing
Electrical shock
Restraint
Drug toxicity
Radiation toxicity
Psychotic drugs
Severe malnutrition
Abnormal environment
LD-50 determination
Intra organ inoculation
Corrosives on skin or cornea
Intra-orbital blood collection
Injection of inflammatory agents
Anesthesia:
Anesthetic:
Duration:
Euthanasia:
Method:
Duration:
Hazardous toxic materials:
Isotopes:
Radiation:
Carcinogens:
Recombinant DNA:
Toxicants:
Malignant cells:
Teratogens:
Comments:
Signed: _________________________
IACUC Chair/Member
Review of Protocol by the Institutional Animal Care and Use Committee
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Animal Use Form (Alabama A&M University)

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Completed 24 July 2020

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