Continuing Review of A PROTOCOL FOR USE OF ANIMALS IN RESEARCH OR TEACHING

IUPUISchool of Science Institutional Animal Care and Use Committee (IACUC)

Submit to: IACUC, c/o School of Science, LD 222, 402 N. Blackford Street, Indianapolis, IN46202-3276

Principal Investigator (P.I.): Protocol #:

Title:

Protocol origination date Approved Species: Approved Total

Amendment dates:

Attach any additional information for each question on a separate document if needed

  1. Have any significant changes been made since the last protocol review or amendment:
    ____No ____Yes (if yes, submit an amendment form with this continuing review)
  2. Number of animals purchased or weaned since last review (indicate genus):
    ______
    Number of animals purchased or weaned since project origination (indicate genus):
    ______
  3. Names of all personnel involved in this project since last review (indicate new personnel)
    University policy on Anesthetic Gas Safety requires researchers and staff to complete an on-line training course before using anesthetic gases

P.I.______/ ______
______/ ______
______/ ______
  1. Describe problems or concerns encountered, especially problems of animal pain or distress:
    Was the attending veterinarian consulted and if not, why? ____N/A ____Yes
  1. [4-A]Have alternatives to this use of animals [4-B]and to procedures involving more than momentary pain or distress appeared since protocol approval? ___No ___Yes (if yes, justify continued animal use)

Specify sources consulted; for databases, give keywords (for alternatives and procedures), years searched (>=10 years), and date of search(“alternative” or equivalent must be a keyword)

  1. What is the funding and status of this project?

Submitted agency and title: ______
Source of funds and title: ______
 Not initiated (anticipated initiation date:) /  Will not be initiated*
 Check if ONGOING /  Completed* / *Automatically terminated if selected

Principal Investigator______Date

OFFICE USE ONLY:Final Expiration Date: Three years from Protocol origination date

APPROVEDDISAPPROVEDTERMINATED

SOS IACUC Signature: Date:

Attending Veterinarian SignatureDate

SOM IACUC SignatureDate

Continuing Review of a Protocol Version 7/23/14-ckk