Purchaser’s Detail *IACUC-approved Protocol Number *Source of fund *Full name of Principal Investigator * Contact of Principal Investigator Office No. / Hp No.: *Email: *Department *Name of requestor *Contact of requestor Office No. / Hp No.: *Email: *Billing party & address (If different from PI’s department) Delivery (subject to availability) Detail *Delivery date *Place of delivery Animal Order Species / Strain Quantity Age / Weight Gender (please circle) Male Female Either Pain category (please circle) B C D E Feed & Bedding Order Feed Bedding Quantity Specification Other special requests Note: Field marked with (*) are mandatory and your order will not be processed if any of these fields are left empty. All orders must reach us by Thursday (12 noon) for delivery in the following week (Tuesday & Thursday delivery for rodents, Wednesday delivery for guinea pigs & rabbits). Feed & bedding delivery is on the 2nd & 4th Monday of the month. Comparative Medicine reserves the right to reject late/urgent order. _______________________________ Principal Investigator’s Signature / Date
Purchaser’s Detail *IACUC-approved Protocol Number *Source of fund *Full name of Principal Investigator * Contact of Principal Investigator Office No. / Hp No.: *Email: *Department *Name of requestor *Contact of requestor Office No. / Hp No.: *Email: *Billing party & address (If different from PI’s department) Delivery (subject to availability) Detail *Delivery date *Place of delivery Animal Order Species / Strain Quantity Age / Weight Gender (please circle) Male Female Either Pain category (please circle) B C D E Feed & Bedding Order Feed Bedding Quantity Specification Other special requests Note: Field marked with (*) are mandatory and your order will not be processed if any of these fields are left empty. All orders must reach us by Thursday (12 noon) for delivery in the following week (Tuesday & Thursday delivery for rodents, Wednesday delivery for guinea pigs & rabbits). Feed & bedding delivery is on the 2nd & 4th Monday of the month. Comparative Medicine reserves the right to reject late/urgent order. _______________________________ Principal Investigator’s Signature / Date
Animal_order_form(1).docx