Request for Purchase of Animals

Midwestern University

Animal Resources Department

Request for Purchase of Animals

Requisition # ______

Purchase Order # ______

IACUC File # ______

Investigator______

Department______Ext.______

Project Title ______

______

Species______

Sex______

Number of animals to be ordered______

Weight range/Age______

Requested Delivery Date______

·  Please note timeframe as stated in AR Procedure for Ordering Animals SOP

o  1 week for orders of <20 rats or <30 mice

o  2 weeks for orders of >20 rats, > 30 mice, rabbits or special orders (pregnant animals, specific weight ranges within 5-10 grams, etc.

o  At Least 1 Month for orders that request litter mates

·  Delivery Dates by Approved Vendor:

o  Mondays: Envigo, Jackson Labs & Charles River Labs

o  Wednesdays: Charles River Labs

Instructions for Ordering:

( ) Order from approved sources previously used by MWU:

ð Envigo ð Charles River Laboratory ð Jackson Laboratory

( ) Order from other licensed vendor indicate below

Name ______License No.______

Address ______
______

**This request will have to be approved by MWU’s consulting veterinarian & IACUC before order can be complete**

( ) Special Instructions______

______

Instructions for caging & care:

( ) House according to AR Standards (i.e. group housing with standard enrichment)

*Standard enrichment is Nestlets for mice; tunnels/huts for rats)

( ) If No, please explain Special Instructions (this MUST be approved in an IACUC protocol)______

( ) Feed, water & care according to AR Standards (i.e. standard rodent chow, cage changed weekly, RO water)

( ) If No, please explain Special Instructions for food, water, care or cleaning of cages. (This MUST be approved in an IACUC protocol): ______

Contact Person to report any health concerns for animals:

Call ______at ______

I agree:

·  to abide by the MWU Research and Animal Care Policy and the “NIH Guide for the Care and Use of Laboratory Animals”;

·  to enter any care given to my animals as part of special care on the animal cage card at the time of procedure;

·  to maintain a record of surgery and post-operative recovery as described in my IACUC protocol;

·  to follow procedures described in my approved protocol; and/or

·  to report the changes from my approved description of animal use.

______

Investigator/Signature Date