Page 1 Form Revised Dec 2016
WICHITA STATE UNIVERSITY
INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC)
FINAL REPORT FORM
Protocol #: Date of Initial Approval:
Expiration Date: Animal Species:
1. RECORD OF ANIMAL USAGE OR IF TISSUE STUDY CLICK HERE AND SKIP TO #2
2. REQUEST PROTOCOL TERMINATION
A. Final Annual Report – De Novo Review – New Protocol #
B. Completed - no further activities with animals will be done.
C. Currently inactive - project initiated but project has not/will not be completed.
D. Inactive - project never initiated.
3. FINAL ANNUAL REPORT
Provide a brief update on the progress made in achieving the specific aims of the protocol. For animal studies,
please include in your answer how animals were utilized and how that fits with the total number of animals
approved for the protocol. Please provide an explanation for any large discrepancy between the number of animals
requested and those utilized. (If additional space is needed to provide a complete answer, please attach a
separate Word document with further information.)