IACUC ANIMAL TRANSFER FORM - Wayne State University

This form is used to transfer animals between protocols (i.e. to another PI, etc.).

A separate Transport form must be filled out if you wish the Division of Laboratory Animal Resources (DLAR) to transport between buildings.

Fields with asterisks (*) are required.

Transfer From

From Principal Investigator Name *

Principal Investigator Email *

Principal Investigator Phone Number *

From Protocol Number *

Species *

Strain *

Number of Cages *

Sex *

Male

Female

Either

Number of Animals *

Were the animals originally received under a Material Transfer Agreement? *

Yes

What procedures have these animals undergone? Please list/describe. *

To Principal Investigator Name *

Principal Investigator Email *

Principal Investigator Phone Number *

To Protocol Number *

What procedures will these animals undergo on the new protocol? Please list/describe. *

Will animals be transported by DLAR? *

Yes -Please submit a Transportation Form

Form Prepared by *