Rederivation of a Mouse Line to Eliminate Pathogens Request /
Animal Care Services
Mouse Models Core

PI: ______Date Submitted:______

Mouse line name (short w/ no unusual characters): ______

Contact person: ______

Contact person info:

Phone #1: ______Phone #2: ______

FAX: ______Pager: ______

Email:______

SERVICE DESCRIPTION: In order to rescue contaminated mouse lines, the MMC will transferpreimplantation stage embryos into clean recipient foster mothers, quarantine the mothers and pups and then test the foster mother to determine if any pathogens are still present.

- Males will be supplied from your colony. Proven stud males from your contaminated mouse line are required.

- Embryo donor females can be provided from the MMC breeding colony. Alternatively, you may provide us with your own embryo donor females if required to keep a line inbred or homozygous.

- Our fees include all mouse costs for donor and recipient strains, and pathogen testing.

- Before service, you will need to provide some information about strain of mouse to be rederived . Please fill out this form and then contact the Mouse Models Core Facility. The manager will arrange a meeting with you to discuss scheduling andany special circumstances or requirements (e.g., a detrimental phenotype or requirement for a different mouse strain)

- All services are performed in the order received and are kept confidential.

Questions and Contact info for this service:

The fee for this service, as well as the electronic version of this form, can be found under the Fees section of MyACS after logging into the following website:

Line background: ______

Strain of donor mice to be used for embryo collection: ______

No. of proven studs provided to MMC (2-8 males, ages 2-5 months): ______

Age of stud males: ______Disposition of stud males: Euthanize ____ Return: ____

Notable phenotypes(e.g., potential developmental problems):______

BILLING INFORMATION

PI: ______

The following Chart Field Stream information must be provided for billing:

* Department ID:

* Fund Code:

* Program Code:

Source of Fund:

Project Code:

Flex Code:

(* items are required)

If the work will be paid for with funds from outside of the University of Florida, they must be paid by check in advance to the ACS Business Office; (352) 392-0526.

PI signature: ______

ANIMAL TRANSFER: We will automatically transfer the rederived animals to the facility/animal room of your choice after clearance of quarantine unless you instruct us otherwise. We can breed rederived mouse colonies for you at minimal extra cost to you. Before we begin, we will need an Institutional Animal Care and Use (IACUC) protocol number for your project, and a location to transfer the mice. The IACUC protocol need only be for the analysis of the animals - the Core Facility has IACUC approved protocols for the procedures used to generate and breed the animals for you.

IACUC number______

Have ACS breed line upon rederivation?______

If “No” to above, transfer animals to Building: ______Room #: ______

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