Fillable TENNESSEE TECHNOLOGICAL UNIVERSITY APPLICATION FOR USE OF ANIMALS (Tennessee Technological University)

Fill Online, Printable, Fillable, Blank TENNESSEE TECHNOLOGICAL UNIVERSITY APPLICATION FOR USE OF ANIMALS (Tennessee Technological University) Form

Use Fill to complete blank online TENNESSEE TECHNOLOGICAL UNIVERSITY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

TENNESSEE TECHNOLOGICAL UNIVERSITY APPLICATION FOR USE OF ANIMALS (Tennessee Technological University)

On average this form takes 17 minutes to complete

The TENNESSEE TECHNOLOGICAL UNIVERSITY APPLICATION FOR USE OF ANIMALS (Tennessee Technological University) form is 4 pages long and contains:

  • 0 signatures
  • 2 check-boxes
  • 66 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Tennessee Technological University

BROWSE TENNESSEE TECHNOLOGICAL UNIVERSITY FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
TENNESSEE TECHNOLOGICAL UNIVERSITY
APPLICATION FOR USE OF ANIMALS
IN TEACHING OR RESEARCH
Institutional Animal Care and Use Committee
Proposal Number
Date Received
Date Reviewed
Review Status
I.
IDENTIFICATION
Principal Investigator ______________________ Telephone ________________________
Other Research Affiliates _____________________________________________________
_____________________________________________________
_____________________________________________________
Department/Unit ________________________ Campus Address____________________
II.
PROJECT
Title Project Period
Project Objectives
Species Number Source
____________________ ______ _________________________
____________________ ______ _________________________
____________________ ______ _________________________
Animals
to be
Used
Note: Applications must be received two weeks prior to the regularly scheduled meeting at which
they are to be reviewed.
Protocol: Please describe the general methods and procedures to be used. Are these methods
standard protocol or novel/new ? Include the specific use of animals in the project
and why their use is necessary. (Attach additional pages if necessary.)
III.
ANIMAL CARE
Housing Location of the Animals:
Hall/Facility Room ______________________
Hall/Facility Room ______________________
Hall/Facility Room ______________________
1. Personnel: Who will provide basic care for the animals used, and what are their credentials?
Name Credentials
2. What veterinarian(s) will oversee medical care for animals used?
Name Address Telephone
3. What, if any, invasive (surgical or otherwise) procedures will be used?
4. What, if any, drugs will be used to minimize animal pain or discomfort?
Class of Drug
Name
Dosage
Other Information
Analgesia
Anesthesia
Tranquilizer
Other
5. If surgery and/or anesthesia are to be used in the project, please provide qualifications for
individuals performing these procedures and documentation of those qualifications. Also
include any additional necessary details related to the surgery that have not been included
in the project description to this point. Please attach additional pages if necessary.
6. Will animals be euthanized? If yes, please give details regarding methods, personnel
to perform the procedures, veterinarian oversight, disposal of the carcass, etc.
7. Please identify potential hazards or risks associated with the handling of your study
organism(s). Describe appropriate strategies to minimize or manage risks as well as plans
for what the researcher(s) will do in the event an injury results from the handling of the study
organism(s).
IV.
ASSURANCE OF COMPLIANCE BY PRINCIPAL INVESTIGATOR
OR ACTIVITY DIRECTOR
I, , agree to conduct this project or activity in
compliance with appropriate provisions of the Animal Welfare Act, the Public Health Service’s
“Policy on Humane Care and Use of Laboratory Animals,” and the Public Health Service’s
“Guide for the Care and Use of Laboratory Animals,” as expressed in the Assurance of
Compliance of Tennessee Technological University.
Signature Date
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

TENNESSEE TECHNOLOGICAL UNIVERSITY APPLICATION FOR USE OF ANIMALS (Tennessee Technological University)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 27 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document