Name: Co-PI Email: Course Instructor Phone: IACUC Contact Department: Daily Animal Health Reporter Facility/Lab Manager OSU Employee Trainer-Animal Welfare, Handling, Procedures OSU Student/Grad/Post-Doc Trainer-Project Hazards; Safety & Emergency Plans Non-employee Subject Matter Expert (SME) (specify below) Other (specify below) Other Role (specify below) Additional Information: Species listed on Protocol Knowledge and experience level for all species listed on this protocol If current level is variable between species on this protocol, summarize differences below: Animal Procedure Categories (click all that apply) Animal Care & Husbandry Animal Monitoring for Distress/Pain/Endpoints Capture (field studies) Analgesia/Anesthesia/Chemical Restraint Handling & Restraint Minor Surgery Identification/Marking/Tagging Major Surgery Breeding Surgical Support Transport Recovery Support Behavioral Testing Euthanasia Administration of Substances Other (specify below) Blood/Fluid/Tissue Collection Participant Roles (check all that apply) Name: Co-PI Email: Course Instructor Phone: IACUC Contact Department: Daily Animal Health Reporter Facility/Lab Manager OSU Employee Trainer-Animal Welfare, Handling, Procedures OSU Student/Grad/Post-Doc Trainer-Project Hazards; Safety & Emergency Plans Non-employee Subject Matter Expert (SME) (specify below) Other (specify below) Other Role (specify below) Additional Information: Species listed on Protocol Knowledge and experience level for all species listed on this protocol If current level is variable between species on this protocol, summarize differences below: Animal Procedure Categories (click all that apply)
Name: Email: Phone: Department: OSU Employee OSU Student/Grad/Post-Doc Non-employee Other (specify below) Co-PI Course Instructor IACUC Contact Daily Animal Health Reporter Facility/Lab Manager Trainer-Animal Welfare, Handling, Procedures Trainer-Project Hazards; Safety & Emergency Plans Subject Matter Expert (SME) (specify below) Other Role (specify below) Additional Information: Species listed on Protocol Knowledge and experience level for all species listed on this protocol If current level is variable between species on this protocol, summarize differences below: Animal Procedure Categories (click all that apply) Animal Care & Husbandry Capture (field studies) Handling & Restraint Identification/Marking/Tagging Breeding Transport Behavioral Testing Administration of Substances Blood/Fluid/Tissue Collection Animal Monitoring for Distress/Pain/Endpoints Analgesia/Anesthesia/Chemical Restraint Minor Surgery Major Surgery Surgical Support Recovery Support Euthanasia Other (specify below) Participant Roles (check all that apply) Name: Email: Phone: Department: OSU Employee OSU Student/Grad/Post-Doc Non-employee Other (specify below) Co-PI Course Instructor IACUC Contact Daily Animal Health Reporter Facility/Lab Manager Trainer-Animal Welfare, Handling, Procedures Trainer-Project Hazards; Safety & Emergency Plans Subject Matter Expert (SME) (specify below) Other Role (specify below) Additional Information: Species listed on Protocol Knowledge and experience level for all species listed on this protocol If current level is variable between species on this protocol, summarize differences below: Animal Procedure Categories (click all that apply)
01_iacuc_protocol_form_2018-11.docx