IACUC Forms

Form Name Additional Form Information
Compliance Cover Page Complete with signatures.
IACUC Application Complete with signatures and certifications
Appendix A – Special Husbandry Complete only if applicable
Appendix B – Hazardous Substances Complete only if applicable
Appendix C – Specimen Collection Complete only if applicable
Appendix D – Surgery Complete only if applicable
Appendix E – Other Experimental Procedures Complete only if applicable
Appendix F – Field Study-Wild Catch Complete only if applicable
Appendix G – USDA Pain Category Chart Informational only
Biology Research Facility Request Form Form used to request the use of animal research facility space from the department of Biology.  See more information here.
Post Mortem Tissue Collection For post mortem tissue collection not covered as part of an existing IACUC protocol
IACUC Extension or Project Termination Use to extend or terminate an approved IACUC protocol.Extension requests must be received by the first day of the month in which the protocol expires.
IACUC Amendment Use to amend an approved IACUC protocol
IACUC Exemption Use to request an exemption approval for field observation studies
Occupational Health Questionnaire For medical clearance to work with animals – medical practitioner required.  Submit completed form to Health Center. Click here for further directions.
Occupational Health Risk Brochure
CITI Training Required IACUC Training required through CITI Program – Log in through GSU to use your institutional account
Form Name Additional Form Information
Weekly Animal Checklist For use by researchers in tracking animal welfare checks.  Must be current and readily available at all times.
Facility Inspection-Biology For use by facility managers and staff and IACUC members in evaluating facility compliance
Facility Inspection- Wildlife Center For use by facility managers and staff and IACUC members in evaluating facility compliance
Adoption Form Contact the Research Compliance Officer prior to use.
Adverse Event Form For use where unanticipated events occur (Vet contact required)
Performance Site Agreement Form To be used where the animal acquisition, care, housing and research are completed at a federally assured facility that is not covered by the GS assurance
Holding Protocol Enrollment Agreement Requires Signature of Chair
Rabies Vaccine Information Sheet CDC Rabies-What you need to know.
Animal Cage Identification Plate Required for all housed animals
IACUC SOP Template Standard format for submission of proposed Standard Operating Procedures for Animal Care and Use at Georgia Southern
Form Name Additional Form Information
Guide for the Care and Use of Laboratory Animals The eighth edition of the Guide for the Care and Use of Laboratory Animals has been reviewed in draft form by individuals chosen for their diverse perspectives and expertise, in accordance with procedures approved by the Report Review Committee of the National Research Council.
Guide for the Care and Use of Agricultural Animals in Teaching and Research – (the Ag Guide-2010) The Federation of Animal Science Societies (FASS) has released the third edition of the Guide for the Care and Use of Agricultural Animals in Research and Training (FASS Ag Guide). The FASS Ag uide serves as a primary reference document for meeting the needs and requirements of agricultural animals utilized in research and teaching.
Animal Welfare Act  Animal Welfare Act in pdf format (1/2017).  Searchable
Good Lab Practice Regulations (FDA and EPA) Comparison Chart of FDA and EPA Good Laboratory Practice (GLP) Regulations and the OECD Principles of GLP
USDA’s Animal Welfare Information Center Information regarding relevant laws, regulations and discussions of animal care and use.
NIH Grant Application Vertebrate Animal Section (VAS) Guidance To clarify information that must be included in the Vertebrate Animal Section (VAS) of grant applications and cooperative agreements that use live vertebrate animals in research.Explains how VAS is evaluated as part of the NIH peer review process and is considered as part of the overall scoring. Distinction is made between the oversight role of the Institutional Animal Care and Use Committee (IACUC) and review responsibility of the NIH Scientific Review Group (SRG).
NIH VAS Worksheet This worksheet is provided to assist applicants in preparing the VAS for submission to the NIH
NIH VAS Fact Sheet 5 points of information to be included in the VAS for each performance site.
Rabies Vaccine Information Sheet CDC Rabies – What you need to know
2013 Report of the AVMA Panel on Euthanasia The following forms may be used in completing IACUC protocols for review

Last updated: 4/28/2017

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