Interinstitutional Room Transfer Form

Interinstitutional Rodent Room Transfer Form (Tufts CMS-HNRCA)

Use this form to request animals be moved from Tufts CMS to the HNRCA or vice versa. Allow a minimum of a week for a response.

Steps for transfers of animals between Tufts CMS and HNRCA.

1. Complete this form

2. If you are transferring the animals to a different protocol, you must also complete the IACUC Animal Protocol Transfer form.

3. Wait for approval for transfer.

4. Obtain shipping crates and crate dividers from CMS Husbandry or HNRCA.Do not transfer animals between CMS and HNRCA in cages.

5. Arrange facility entry/animal transfer.

Click the "Submit" button at the bottom left of this form when it is complete to send it to the Tufts CMS and CBU staff.

Your name*

Your e-mail address*

Your Email*

Species to be transferred*

If "other," give species*

Number of cages*

Reason for Transfer?*

Requested transfer date or approximate timeframe desired*

On which IACUC protocol will the procedures be done?

PI name*

IACUC protocol number*

Note: If the animals are not currently housed on the above protocol, you must complete an IACUC Protocol Transfer form prior to transfer of the animals. http://viceprovost.tufts.edu/iacuc/forms-and-acronyms/

Animals will be transferred: (Check all that apply)

From CMS to HNRCA for same day terminal experimentsFrom CMS to HNRCA for >24 hoursFrom HNRCA to CMS for same day terminal experimentsFrom HNRCA to CMS for >24 hours

CMS housing room:*

HNRCA housing room

Account number for animal housing billing*

How long will the animals be housed at HNRCA?*

How long will the animals be housed at CMS?*

E-mail addresses (separated by semicolon) of anyone (besides you, CMS staff, and CBU staff) who needs to receive notification of transfer approval

These animals are housed under:

ABSL1 containment (no infectious disease or agents approved for ABSL1 containment)ABSL2 containment (agents approved by IBC registration for ABSL2 containment)

Are there any special husbandry needs?

Notes: