NY State DEA (For Non-MD Only) NOTE: CONTROLLED DRUGS MUST BE KEPT UNDER DOUBLE LOCK. (A LOCKED BOX WITHIN A LOCKED DRAW OR CABINET OR A PERMANENT SAFE IS ACCEPTABLE). ALSO, A CONTROLLED DRUG LOG MUST BE KEPT WITH THE CONTROLLED SUBSTANCE. THE DRUG LOG MUST INCLUDE LOT NUMBER, BOTTLE NUMBER, DATE USED, AMOUNT USED, SPECIES USED UPON, AMOUNT REMAINING, AND INITIALS OF INDIVIDUAL THAT USED CONTROLLED SUBSTANCE. FOR ADDITIONAL INFORMATION REGARDING THIS MATTER, PLEASE VISIT THE FOLLOWING WEBSITE: http://www.health.state.ny.us/professionals/narcotic/ Human Tissues (Reminder). Any work involving human patient samples in animals must have approval by the Committee on Clinical Investigations (CCI). Does this study involve human tissues? No. Proceed to 31. Yes. Proceed to 31A. 30A. Have you obtained CCI approval? No. Please contact CCI and proceed to item 26. Yes. If you you MUST attach CCI “Yes”, Proceed to 31. approval letter to protocol. Stem Cell Research (Reminder). Any work involving embryonic stem cell research in animals must have approval by the Embryonic Stem Cell Research Oversight Committee (ESCRO). Does this study involve stem cell research in animals? No. Proceed to 32. Yes. Complete 31A. 31A. Have you obtained ESCRO approval? No. Please contact ESCRO and proceed to 32. Yes. Proceed to 32. REMINDER: ANIMALS USED FOR STEM CELL RESEARCH MAY NOT BE BRED. APPENDICES: CHECKLIST ATTACHED - Please check appropriate boxes and READ item 33. Appendix 1 SPECIAL HUSBANDRY PRACTICES – Appendix 2 TEST SUBSTANCES – Appendix 3 SPECIMEN COLLECTION TO EUTHANASIA – Appendix 4 MONOCLONAL ANTIBODY COLLECTION – Appendix 5 SURGERY – Appendix 6 CORE FACILITIES (MAY NOT BE USED FOR BEHAVIORAL CORE) – Appendix 7 OTHER EXPERIMENTAL PROCEDURES OR BEHAVIORAL CORE – Appendix 8 BIOSAFETY/CHEMICAL SAFETY PRECAUTIONS (If you completed Appendix 8 – YOU MUST ATTACH all appropriate SOPs and Hazardous SIGNATURES: Please do not submit at this time. Signatures will be required on the final version of the animal use protocol. You will receive an e-mail (along with a signature sheet) requesting signatures on
NY State DEA (For Non-MD Only) NOTE: CONTROLLED DRUGS MUST BE KEPT UNDER DOUBLE LOCK. (A LOCKED BOX WITHIN A LOCKED DRAW OR CABINET OR A PERMANENT SAFE IS ACCEPTABLE). ALSO, A CONTROLLED DRUG LOG MUST BE KEPT WITH THE CONTROLLED SUBSTANCE. THE DRUG LOG MUST INCLUDE LOT NUMBER, BOTTLE NUMBER, DATE USED, AMOUNT USED, SPECIES USED UPON, AMOUNT REMAINING, AND INITIALS OF INDIVIDUAL THAT USED CONTROLLED SUBSTANCE. FOR ADDITIONAL INFORMATION REGARDING THIS MATTER, PLEASE VISIT THE FOLLOWING WEBSITE: http://www.health.state.ny.us/professionals/narcotic/ Human Tissues (Reminder). Any work involving human patient samples in animals must have approval by the Committee on Clinical Investigations (CCI). Does this study involve human tissues? No. Proceed to 31. Yes. Proceed to 31A. 30A. Have you obtained CCI approval? No. Please contact CCI and proceed to item 26. Yes. If you “Yes”, you MUST attach CCI approval letter to protocol. Proceed to 31. Stem Cell Research (Reminder). Any work involving embryonic stem cell research in animals must have approval by the Embryonic Stem Cell Research Oversight Committee (ESCRO). Does this study involve stem cell research in animals? No. Proceed to 32. Yes. Complete 31A. 31A. Have you obtained ESCRO approval? No. Please contact ESCRO and proceed to 32. Yes. Proceed to 32. REMINDER: ANIMALS USED FOR STEM CELL RESEARCH MAY NOT BE BRED. APPENDICES: CHECKLIST ATTACHED - Please check appropriate boxes and READ item 33. Appendix 1 – SPECIAL HUSBANDRY PRACTICES Appendix 2 – TEST SUBSTANCES Appendix 3 – SPECIMEN COLLECTION TO EUTHANASIA Appendix 4 – MONOCLONAL ANTIBODY COLLECTION Appendix 5 – SURGERY Appendix 6 – CORE FACILITIES (MAY NOT BE USED FOR BEHAVIORAL CORE) Appendix 7 – OTHER EXPERIMENTAL PROCEDURES OR BEHAVIORAL CORE Appendix 8 – BIOSAFETY/CHEMICAL SAFETY PRECAUTIONS (If you completed Appendix 8 YOU MUST ATTACH all appropriate SOPs and Hazardous SIGNATURES: Please do not submit at this time. Signatures will be required on the final version of the animal use protocol. You will receive an e-mail (along with a signature sheet) requesting signatures on
Animal%20Use%20Protocol%20-%20Revised%2011-2017.docx