CAF-EMIF +41 (0)21 314 6886
Rue du Bugnon 27 +41 (0)21 314 7977
1005 Lausanne www.unil.ch/caf/emif
Switzerland
REQUEST FOR ECHOCARDIOGRAPHIC SERVICES
GENERAL INFORMATION
Investigator: Date of request:
Department/Division :
Address:
Phone: Fax: Email:
1. State specific question to be addressed and a brief description of the project:
2. Specify genetic background, strain, transgenic or knockout:
3. Number of animals:
4. Authorization number (must be obtained prior to study) :
SCREENING ECHOCARDIOGRAMS Check Services Requested
1. BASIC ECHOCARDIOGRAM
Non-invasive transthoracic cardiac ultrasound exam performed under light general anesthesia that includes two-dimensional and M-mode images of the left ventricle. Includes analyses and representative images.
2. BASIC ECHOCARDIOGRAM + DOPPLER
Basic echocardiogram plus Doppler recording of trans-valvular flow indices (gradients) and aortic flow.
3. BASIC ECHOCARDIOGRAM + TISSU DOPPLER
Basic echocardiogram plus Doppler recording of mitral annulus velocity.
OTHER SERVICES
4. ORGAN HARVEST
Includes body weight : heart weight ratio, slicing tissue, and preservation in formalin or liquid nitrogen. Blood can also be retrieved and stored.
5. OTHER MODALITIES
Abdominal ultrasound, ultrasound of tumors, artery ultrasound, and other modalities available upon request. Please contact CAF for more information.
CHARGES
If you are interested in receiving an evaluation order, contact us at
Terms
1. Legal approval from the cantonal veterinary office must be obtained by the investigator before starting experiments.
2. Investigator is responsible for transferring animals to the CAF housing facility, Rue du Bugnon 27, and for retrieving animals or preserved tissue samples at the end of the study.
3. Housing costs will be charged to the investigator.
4. Service will be charged according to service actually provided.
5. For safe of security, all echographic services are performed by CAF staff.
I agree to follow the terms and conditions described in this application.
I understand the terms and fees for the requested services.
P.I. Signature Date
Billing contact person: Phone number:
Guidelines and Policies
Application for Services
The laboratory requesting service of the CAF agrees to provide the required animals for the planned experiments, and to pay the CAF the appropriate fees. The applicant also acknowledges and accepts that the final price and total number of animals required to complete the test may vary according to difficulties encountered specifically with some rodent models.
Data and Data Ownership
All data will be processed, presented in an appropriate way and sent as an electronic document to the applicant. The CAF personnel will be available to discuss various aspects of the test, including experimental details and interpretation of the results.
All data generated upon request in the CAF strictly belong to the applicant investigator and his institution. Thus, this data cannot be used by the CAF personnel for personal or institutional research purposes unless a formal, written agreement of collaboration is established between CAF personnel and the investigator.
Pricing policy
Price information is available for each test on the Request for services forms. A written estimate of the fees must be signed by the applicant before animals can be shipped to the Center.
Acknowledgements & Authorship
Investigators are expected to acknowledge the use of the CAF in their publications. In addition, whenever time-consuming, labor-intensive experiments that require substantial scientific input are performed, the contribution of the CAF staff should be recognized as a scientific collaboration, and involved CAF collaborators will be authors in resulting publications