IACUC Forms

Please note that as of July 1, 2012 only the "2012" or newer version of the Protocol, Protocol and Personnel Amendment and Surgical Addendum will be accepted by the IACUC Office.  

Please submit all completed forms as email attachments to the IACUC Office. You must have Acrobat Reader version 8.0 or higher to use these forms. Click on the adobe icon to download the most recent version (free).

Get Acrobat Reader 

It is highly recommended that when accessing the forms that you 'right click' on the appropriate hyperlink and select 'save target as...' to save these files directly to your hard drive. After saving, close the web document and open the newly saved local document.  This will avoid any issues that might arise when trying to save completed documents opened from the web.

  Protocol Forms

open document in PDF format Protocol Form (2012 version)
open document in PDF format Bioproducts Protocol Form (2010 version) - For use when no live animals are used, i.e., for bioproducts, cadavers, tissues

Amendment Forms 

open document in PDF format Protocol Amendment Form (2012 version) - remember to submit appropriate addenda (Breeding, Surgical)
open document in PDF format Personnel Amendment Form (2012 version) - Use this form to add and delete personnel on an approved protocol.  Form must be submitted by someone already listed on the protocol.

Breeding, Surgical and GLP Addenda (Include with Protocol and Amendment Submissions that include Rodent Breeding, Surgery or GLP activities)

open document in PDF format Rodent Breeding Addendum (2012 version)                 
open document in PDF format Surgical Addendum (2012 version)
open document in PDF format Good Laboratory Practices (GLP) Studies Addendum (2009.1 version)

Hazardous Materials Addendum (include with 2011 Protocol and Amendment Submissions with Hazards)

open document in PDF format Hazardous Materials Addendum (2011 version) Use with 2011 Protocol and Amendment forms ONLY

Other forms

download document in MS Word Animal Hazards Checklist - For traditional laboratory locations
download document in MS Word Animal Hazards Checklist - For field studies
download document in MS Word Cervical Dislocation/Decapitation/Retro-Orbital Bleeding/Injection Certification Form
download document in MS Word Loss Compensation Insurance Claim Application Form
download document in MS Word Emergency Contacts Sign
download document in MS Word Request to transfer animals from an expiring protocol to an active protocol (processed by IACUC Office)           
download document in MS Word Sample Standard Operating Procedure (SOP) Document for Laboratory Housed Animals
download document in MS Word Daily Animal Care Assessment - PI Lab            
download document in MS Word Controlled Substance Disposition Record
download document in MS Word Controlled Substance Personnel Log
download document in MS Word Controlled Substance DEA Annual Inventory Form
download document in MS Word Guillotine Use and Maintenance Log   
download document in MS Word Analgesia Record

Who can I contact for help?

  • Contact the IACUC Office for assistance with completion of the forms, which forms and addenda are needed, and approximate timelines for approval.
  • Call 626-1247 if you need any help downloading or completing the forms.
  • A UAC veterinarian should be consulted in the planning of procedures involving more than minimal pain and/or distress (e.g., surgery, death as an endpoint, restraint, etc...).