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University of Alaska Fairbanks :: Center for Research Services :: Office of Research Integrity :: IACUC :: Forms

 

Forms

 

IACUC Assurances: All IACUC forms must be submitted electronically to fyiacuc@uaf.edu. Questions should be directed to the Research Integrity Administrator (907-474-7800).

Assurance of Animal Care - this form is to be used for all new protocol submissions and three-year mandatory resubmissions. All sections must be completed, although "Not Applicable" may be an acceptable response in some situations. The Assurance is intended to be an independent document, therefore you may not refer to previous submissions or other documents in your answers. You may refer to the following supplements which may be submitted as part of the application packet. Instructions for completing the Animal Use Procedures and Hazardous Agents sections are available as a separate document.

Surgery Supplement - this form is to be used for all surgical procedures (survival and non-survival). It may be submitted with a new Assurance of Animal Care application or with a Modification Request.

Personnel Supplement - this form is to list additional personnel when you have used all the available space on the Assurance of Animal Care form.

Species Supplement - this form is to be used to list additional study species when you have used all the available space on the Assurance of Animal Care form.

Rationale for the Continued Use of Animals - This form is required for all mandatory three-year rewrites of IACUC Assurances of Animal Care. The information provided will assist the IACUC in their evaluation of your new submission.

Modification Request - this form must be completed and submitted for all significant changes to approved Assurance of Animal Care that are currently active. A list of the most common significant changes provides some guidance. Contact the Office of Research Integrity or IACUC Chair for specific guidance on when a Modification is required.

Continuing Review - Please use this form to renew or close an IACUC Assurance. IACUC Assurances are valid for a maximum of three years (original approval plus approval of up to two annual continuing reviews). It is the PI's responsibility to ensure that the completed form is received by the IACUC in time to be reviewed at the meeting preceeding the expiration date (stated on the Approval Letter).

Note: As a courtesy the Office of Research Integrity will typically notify the project PI six to eight weeks prior to the due date.

Breeding Colony or Herd Management Plan - this form must be completed for all UAF breeding colonies or herds. The form was created because we were recently advised by regulatory officials that they expected the IACUC to review all uses of animals, including use of animals in breeding programs.

Modification - Please make changes directly in the approved Management Plan. Each change must be clearly identifiable (we suggest a contrasting font color or highlighting). Send the updated Management Plan to fyiacuc@uaf.edu with "Modification Request" in the subject line.

Continuing Review - Annual Continuing Review is required for Management Plans. The form will be linked from this site as soon as it is available.

 

Personnel Forms

Personnel Information Form - All personnel working on an IACUC Assurance are required to submit this form. This form should also be used to enroll in the occupational health & safety program and/or apply to become authorized to use controlled substances in conjunction with an IACUC Assurance. This form must be submitted annually to the Office of Research Integrity.

Medical Questionnaire - initially, this form should only be filled out at the direction of the office of research integrity. However, if you have already been assigned to risk category 2 or 3 and have had a significant change in your health status you may fill out this form at any time. Send this form directly to the contract health care provider by fax or regular mail; do NOT send it to the Office of Research Integrity.

 

Quality Improvement Program

Quality Improvement Report - this form may be submitted by anyone with concerns about animal care and use, specific IACUC protocols, occupational health & safety or other issues related to the UAF Animal Facilities.

QIP Assessment Checklist (IACUC) - this form will be completed by the Sr. Research Compliance Officer as part of the a periodic assessment of research programs utilizing live vertebrates.

UAF Animal Facilities

Space Request Form - Use this form to request space within the Irving I or Biological Research & Diagnostics Building animal facilities. Send the completed form to the Animal Quarters Supervisor.

 

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This site was last updated May 6, 2008 by Kelly Hochstetler

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