IACUC Personnel Amendment Request Form

IMPORTANT: The eProtocol system only allows the submission/processing of one amendment (or annual review) at a time. Because amendments to add personnel can take a long time if training has not been completed, the IACUC recommends that this form be submitted before the change is made in eProtocol. Once the new person completes all the training requirements (i.e. CITI, AniCon Questionnaire, DLAR) the PI can add him/her to the eProtocol via an amendment. This process will allow Investigators to continue to submit general amendments while the new lab personnel complete their training requirements. Please contact the IACUC office at 313-577-1629 if you have any questions regarding the process. This form should be submitted to iacuc@wayne.edu.

Fields with asterisks (*) are required.

Personnel Information (To be Added)

Personnel Name to be Added *

WSU AccessID *

Personnel Email Address *

Personnel Telephone Number *

Protocol Information

Protocol Number(s) *

Principal Investigator *

Prinicpal Investigator Email Address *

Personnel Experience and Responsiblites

Personnel will need to be trained on the following SPECIES *

Please specify the specific role of the new lab personnel in the project. Examples may include tasks such as animal care, handling/ restraint, blood collection, breeding, pre-treatments, oral gavage, anesthesia administration, injections, post-procedural care, and euthanasia in the specified species. *

Will this lab personnel perform or assist with any surgical procedures? *

Yes

If yes, which type of surgery will the lab personnel perform?

Survival

Non-Survival

Will this personnel take care of animals outside of DLAR (>12 hrs)? *

Yes

Form Submitted By *

Submitter's Email Address *

Date Submitted *