Maintenance and Animal Observation Form (rev. 9/10)
Download this form in Word. When finished, e-mail the form to the Attending Veterinarian, John Young, for review. After his review, e-mail the form to email@example.com for placement on an IACUC meeting agenda.
(Note: This form must be typed; handwritten forms will not be accepted.)
|IACUC Project Number:
- Responsible Faculty Member
- Office Location:
- E-mail Address:
- Provide a brief explanation and rationale for maintenance and observation of animals in
- Animal Information
- Breeding Necessary: Yes ____ No ____
- Vendor Source:
- Number to be maintained:
- Animal Housing Location (Bldg/Rm):
- Animal Facilities
- Description of primary enclosure (housing unit for animals).
- Description of routine husbandry including frequency of activity (feeding, watering, cage sanitation,
environmental temperature, etc.).
- Provisions for husbandry of animals during weekdays, weekends, holidays, vacations, etc.
- Provisions for veterinary consultation and/or euthanasia in the event of a health problem.
|Signature and Date: