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Marine Biological Laboratory
APPENDIX A
APPLICATION TO USE
CONTROLLED SUBSTANCES
INSTRUCTIONS:
This form should
be completed by the Responsible Researcher.
Submit the Form to the
MBL Attending Veterinarian:
Vet@mbl.edu
Department/Course:
Date:
Responsible Researcher:
Phone:
Storage Location: I Building:
Room:
Name of Controlled Substance Drug
Code Drug
Schedule
1.
2.
3.
4.
Authorized Individual*
Location Phone Number
1.
2.
3.
4.
*Persons
previously convicted of
a
felony relating to Controlled
Substances, or
who had an application for
registration with
a
Federal
or
State agency
denied, or
who surrendered a registration "for cause" may not be authorized
to
work with
the Controlled Substances.
Signature of Responsible Researcher: ___________
Date:
___ _
MBL Controlled Substances Policy - April 2019
click to sign
signature
click to edit