Page 1 Form Revised April 2018
WICHITA STATE UNIVERSITY
INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC)
ANIMAL TISSUE FORM
This abbreviated form is to be complete for research projects that utilize animal parts but do not actually require the use of
“live” animals. For example, projects that utilize material from slaughterhouses or local farms would employ this article.
This exercise is intended to allow the WSU IACUC to maintain knowledge of all animal-related research on the campus.
Co-Investigator Name(s) and Titles (faculty, grad student, etc):
Anticipated Start Date: Anticipated End Date:
1. Species and tissue(s) to be utilized:
2. Source of animal material: (List the name(s) of the sources of the animal tissues, for example Yoder Meats,
Yoder, KS. If coming from another approved protocol, please list the protocol number.)
3. Provide brief description of disposal methods for animal tissues.