Request to Transfer Animals Between Animal Use Protocols

1. To request relocation of rodents within MCG Animal Rooms, please complete this form and send to CB 1901.
2. After the relocation is approved, you will be notified by e-mail.
3. Missing information may cause delays in processing the request.

Animals: Species: Strain:

Number of Animals: Number of Cages:

(If cages need to be moved the PI must mark the cages with transfer stickers (Pink)

available in CB 1102)

Animal have not been used (e.g., surplus animals, extras) or

Animal were used in the following manner (please describe previous use):

Current Location: Building: Room:

Principal Investigator: Department:

Protocol Number:

Transfer Location: Building: Room:

Principal Investigator: ______________________________ Department:

Please Print

Phone #

Protocol Number:

Note: If the PI has changed and/or protocol number has changed the cage card must be corrected by PI within 48 hours.

LAS to move animals: PI will move animals:

Signatures

Transferring PI: Date:

Receiving PI: Date:

Submit this signed original to Mr. Rennie Wolfe, Dr. Charlton or Dr. Rodriguez for LAS Approval, CB 1901

LAS Approval: Date:

Animals were moved by: __________________________________________ Date: ______________

(NAME)